Helping Anesthesiologists Understand Facial Fractures

Robertson, Chad; Doucet, Jean-Charles

doi:10.1016/j.coms.2013.07.005

Cited by 10 publications

(11 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Airway assessment: It is done as quickly as possible to prevent hypoxia and hypoxemia. Patient has to be evaluated for loss of consciousness, loss of spontaneous breathing and severity and extent of injury [26,27] . A quick assessment of airway is done by LEMON assessment.…”

Section: Management Of Maxillofacial Injury Emergency Managementmentioning

confidence: 99%

“…A quick assessment of airway is done by LEMON assessment. It consists of Look externally to detect difficult airway predictors, such as short neck, Evaluate mouth opening and thyromental distance, Mallampati class, Obstruction of the upper airway and Neck mobility [27,28] . Apart from this additional predictors for difficult airway are taken into account like presence of blood or vomitus in airway, cervical spine immobility, airway oedema and obesity.…”

Section: Management Of Maxillofacial Injury Emergency Managementmentioning

confidence: 99%

“…Elective management is surgical reduction and immo-bilization (Intermaxillary fixation) [27] . Main concern for elective surgery is airway control and blood loss.…”

Section: Elective Managementmentioning

confidence: 99%

See 2 more Smart Citations

Anesthetic Challenges and Management of Maxillofacial Trauma

Gupta¹,

Singh²,

Kumar³

et al. 2017

JAS

View full text Add to dashboard Cite

Management of Maxillofacial trauma is a challenging task for an anaesthesiologist. It requires a prompt and skillful response from the anaesthesia team. Bilateral parasymphsial fracture, condylar fracture, fracture of zygoma, flattening of face, moderate bleeding and derranged occlusion are the main cautionary pointers of difficult airway. Emergency airway management should be done by a team led by an anaesthesiologist. A difficult airway cart along with resuscitation trolley should be ready. Plan A should be direct laryngoscopy and manual in line stabilization. Video laryngoscope if available should be preferred. Plan B must include fiberoptic, optical and lighted stylets and airway rescue supraglottic devices. Surgical access should be used as backup plan C. Elective management for definitive surgery should be based on specific maxillofacial trauma, surgical approach, associated inflammation and need of prolonged mechanical ventilation in postoperative period.

show abstract

Section: Management Of Maxillofacial Injury Emergency Managementmentioning

confidence: 99%

Section: Management Of Maxillofacial Injury Emergency Managementmentioning

confidence: 99%

See 1 more Smart Citation

Anesthetic Challenges and Management of Maxillofacial Trauma

Gupta¹,

Singh²,

Kumar³

et al. 2017

JAS

View full text Add to dashboard Cite

show abstract

“…Are the bony structures of the face involved? In cases of massive injuries, mask ventilation may be impossible, while injury limited to the soft tissues may enable mask ventilation [ 33 ]. For quick and easy identification of factors that may predispose difficult intubation or ventilation, one may use the LEMON assessment [ 33 , 34 ].…”

Section: Approach To the Airway Of The Patient With Maxillofacial mentioning

confidence: 99%

“…In cases of massive injuries, mask ventilation may be impossible, while injury limited to the soft tissues may enable mask ventilation [ 33 ]. For quick and easy identification of factors that may predispose difficult intubation or ventilation, one may use the LEMON assessment [ 33 , 34 ]. The components of this assessment are as follows: look externally to detect difficult airway predictors, such as short neck and evaluate mouth opening and thyromental distance, Mallampati class, obstruction of the upper airway that may be noticed by stridor, and neck mobility.…”

Section: Approach To the Airway Of The Patient With Maxillofacial mentioning

confidence: 99%

Airway Management of the Patient with Maxillofacial Trauma: Review of the Literature and Suggested Clinical Approach

Barák

Bahouth

Leiser

et al. 2015

BioMed Research International

View full text Add to dashboard Cite

According to the Advanced Trauma Life Support recommendations for managing patients with life-threatening injuries, securing the airway is the first task of a primary caregiver. Airway management of patients with maxillofacial trauma is complex and crucial because it can dictate a patient's survival. Securing the airway of patients with maxillofacial trauma is often extremely difficult because the trauma involves the patient's airway and their breathing is compromised. In these patients, mask ventilation and endotracheal intubation are anticipated to be difficult. Additionally, some of these patients may not yet have been cleared of a cervical spine injury, and all are regarded as having a full stomach and having an increased risk of regurgitation and pulmonary aspiration. The requirements of the intended maxillofacial operation may often preclude the use of an oral intubation tube, and alternative methods for securing the airway should be considered before the start of the surgery. In order to improve the clinical outcome of patients with maxillofacial trauma, cooperation between maxillofacial surgeons, anesthesiologists, and trauma specialists is needed. In this review, we discuss the complexity and difficulties of securing the airway of patients with maxillofacial trauma and present our approach for airway management of such patients.

show abstract