Skip to Main Content

++

Chapter 27. Airway Management for Penetrating Facial Trauma

++
++
++

The patient above presents in tripod position to maintain adequate breathing. Blow-by oxygen is provided by mask. Appropriate strategies to initially secure the airway would NOT include

++
++
++

A. keep the patient seated upright during awake look

++
++

B. attempt blind nasal intubation

++
++

C. assemble equipment for cricothyrotomy

++
++

D. call for immediate assistance from a surgical colleague

++
++

E. use of personal protective equipment

+
++

(B) In general, in the presence of an altered airway anatomy (e.g., facial trauma), the use of a “blind” airway technique would be inappropriate.

++
++
++

In the above scenario, when would a primary cricothyrotomy be appropriate?

++
++
++

A. on initial presentation

++
++

B. once the surgical colleague arrives

++
++

C. after the initial attempt at awake look fails while oxygen saturation is 98%

++
++

D. persistent oxygen desaturation

++
++

E. with nasal hemorrhage that prevents blind nasal intubation

+
++

(D) In the presence of persistent oxygen desaturation, cricothyrotomy would be an appropriate option.

++
++
++

The incidence of associated unstable cervical spine fracture in a neurologically intact patient with penetrating facial trauma

++
++
++

A. is negligible

++
++

B. is not a concern provided a cervical collar that provides rigid immobilization is used

++
++

C. ranges from 1% to 2.6% of patients

++
++

D. in some studies approaches 20%

++
++

E. has never been studied

+
++

(A) To date, there have been no cases reported of isolated penetrating injury to the face that have resulted in an unstable cervical spine fracture in an awake, alert, neurologically intact patient.

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.