The emergency control of traumatic maxillofacial haemorrhage

Harris, Tim; Rice, Stephen K.; Watts, Beverley; Davies, Gareth E.

doi:10.1097/mej.0b013e32832b7cd3

Cited by 17 publications

(19 citation statements)

References 13 publications

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“…4 Medical care must be provided quickly, so that the patient neurological status is assessed as soon as possible. 5 In our review we saw that young adults were more likely to suffer a maxillofacial trauma (Mean age of 34,6 ± 8,32 years). However, older patients were found to have the highest number of complications, including brain injury, which might be due to impaired capacity to heal and less physiological reserve, compared to younger patients.…”

Section: Discussionmentioning

confidence: 82%

Glasgow in Maxillofacial Fractures Patients: Mini Review

Cascarani¹,

Barletta²,

Tacchelli³

2020

IJISRT

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Background: Maxillofacial traumas are the most frequent one, and are usually associated with brain injuries that can be measured by the Glasgow Coma Scale (GCS).Material and Methods: We did a mini review of the literature using PubMed as our data base, using “maxillofacial trauma and Glasgow Coma Scale” as key words. Among 73 articles found, we selected 3 articles that together analyzed 213 patients. Results: It was found that male patients (77,4%) were more affected than female (22,5%), the average age was 34,6 ±8,32 years, and the most common mechanism of trauma was vehicle accident. Just 10 patients presented a score between 14 and 15 on the GCS, which showed that most patients had neurological damage in different degrees.Conclusions: It was found that there is a relation between maxillofacial trauma and a decreased level of consciousness. Although, the literature lacks of studies analyzing the relation and presence of an altered mental status and the occurrence of a maxillofacial trauma.

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Section: Discussionmentioning

confidence: 82%

Glasgow in Maxillofacial Fractures Patients: Mini Review

Cascarani¹,

Barletta²,

Tacchelli³

2020

IJISRT

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“…Life-threatening hemorrhage is reported as occurring secondary to blunt facial trauma in 0-24.4% of patients,4) reflecting the lack of a standardized definition due to large variance. In the present study, we defined life-threatening hemorrhage as oronasal bleeding uncontrollable by the general rescue strategies listed above.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Treatment to Stop Life-threatening Bleeding from Branches of the External Carotid Artery in Patients with Traumatic Maxillofacial Fracture

Lee

Shim

Chung

2016

J Cerebrovasc Endovasc Neurosurg

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ObjectiveThe purpose of this study was to report our preliminary experience with endovascular treatment (EVT) for life-threatening bleeding from branches of the external carotid artery (ECA) in patients with traumatic maxillofacial fractures.Materials and MethodsA total of 12 patients seen between March 2010 and December 2014 were included in this study. All subjects met the following criteria: 1) presence of maxillofacial fracture; 2) continuous blood loss from oronasal bleeding; and 3) EVT to stop bleeding. Various clinical factors were recorded for each patient and the correlations between those factors and clinical outcome (Glasgow Outcome Scale, GOS) were evaluated.ResultsFour patients were injured in traffic accidents, five in falls, and three by assaults. Mean initial Glasgow Coma Scale (GCS) was 6.9 ± 2.1 and the lowest hemoglobin measured was mean 6.3 ± 0.9 g/dL. GOS at discharge was 4 in five patients, 3 in three patients, and 1 (death) in four patients. GOS on follow-up (mean 13.7 months) was 5 in two patients, 4 in three patients, and 3 in three patients. Initial GCS (p = 0.016), lowest systolic blood pressure (p = 0.011), and lowest body temperature (p = 0.012) showed a significant positive correlation with good clinical outcomes. The number of units of red blood cells transfused (p = 0.030), the number of units of fresh frozen plasma transfused (p = 0.013), and the time from arrival to groin puncture (p < 0.001) showed significant negative correlation with good clinical outcomes.ConclusionIt might be suggested that rapid transition to EVT could be preferable to struggling with other rescue strategies to stop life-threatening bleeding from branches of the ECA in patients with traumatic maxillofacial fractures.

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“…Maxillofacial bleeding: Severe life threatening bleeding can occur due to isolated facial trauma but shock from hemorrhage is uncommon [50][51][52] . Emergency surgery is generally not required until life threatening hemorrhage is present.…”

Section: Cervical Spine Injurymentioning

confidence: 99%

Anesthetic Challenges and Management of Maxillofacial Trauma

Gupta¹,

Singh²,

Kumar³

et al. 2017

JAS

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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.

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The emergency control of traumatic maxillofacial haemorrhage

Cited by 17 publications

References 13 publications

Glasgow in Maxillofacial Fractures Patients: Mini Review

Glasgow in Maxillofacial Fractures Patients: Mini Review

Endovascular Treatment to Stop Life-threatening Bleeding from Branches of the External Carotid Artery in Patients with Traumatic Maxillofacial Fracture

Anesthetic Challenges and Management of Maxillofacial Trauma

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