Maxillofacial trauma includes tooth trauma, soft tissue tear injury, and soft tissue contusion. These injuries can cause life-threatening situations such as suffocation, bleeding, shock, and head injury. When such injuries occur in daily life, timely diagnosis and treatment should be carried out to avoid further aggravation or infection. This article will introduce how to handle such emergency situations correctly.
1、 Common Maxillofacial Trauma
1.1 Dental Trauma
If all permanent teeth are dislocated during dental trauma, it is necessary to promptly locate the missing teeth and avoid touching the root of the teeth. Store in milk, salt water, saliva, and avoid wrapping with tissues. The failure rate of tooth replantation significantly increases after 2 hours. If the tooth is partially broken, find the fragments and keep them for later repair and use. If it is tooth displacement, bite will be affected. Avoid gritting your teeth and shaking them on your own, and seek medical attention promptly before taking an X-ray for examination.
1.2 Soft tissue contusions
Intermittent ice packs should be applied within the first 48 hours after injury (with a towel separating the ice pack from the skin) to avoid further swelling and timely anti infection treatment. Due to prominent cheekbones and weak bone structure in the zygomatic arch, swelling in the cheekbones also requires medical examination for fractures.
1.3 Soft tissue tear injury
Soft tissue tear is characterized by uneven edges, excessive bleeding, and a high risk of secondary infection. Immediately compress and stop bleeding after injury, perform debridement and suturing surgery within 24-48 hours, and inject tetanus antitoxin or tetanus immunoglobulin as early as possible.
2、 Emergency treatment after maxillofacial trauma
2.1 Emergency treatment for asphyxia
If there are blood clots, vomit, free tissue blocks, or foreign objects in the mouth and nasopharynx after injury that cause blockage of the throat, tissue displacement, or tissue swelling, suffocation can occur. In such situations, there are usually symptoms such as restlessness, pale complexion, twitching of the nose, three concave patches, cyanosis of the lips, decreased blood pressure, dilated pupils, and difficulty breathing or suffocation. At this time, the cause should be quickly identified and rescue should be actively carried out.
2.1.1 If blood clots or secretions block the throat, quickly remove the obstruction by hand or use a plastic tube to suck out the blockage to relieve suffocation, while adopting a lateral or prone position.
2.1.2 If the tongue falls behind and causes suffocation, a thick thread or pin should be threaded through the entire lip tongue tissue about 2cm behind the tip of the tongue, the tongue should be pulled out of the mouth, and the pulling wire should be fixed to a bandage or clothing.
2.1.3 If the throat swells and compresses the respiratory tract, any form of ventilation duct should be inserted through the oral or nasal cavity to relieve suffocation.
2.2 Emergency treatment of bleeding
2.2.1 Compression hemostasis method: First, reset the soft tissue, then cover the injured area with multiple layers of gauze dressing, and then apply pressure with a bandage to stop bleeding. You can also compress the proximal segment of the bleeding artery with your fingers to temporarily stop the bleeding, and then use other methods to further stop the bleeding.
2.2.2 Ligation of blood vessels for hemostasis: It is a commonly used and reliable method of hemostasis that requires sterile operation. In emergency situations, the severed end of the blood vessel can be clamped with a vascular clamp and properly wrapped together with the clamp before being transported.
2.2.3 Medication hemostasis methods: There are two types: local medication and systemic medication. It can be used in combination with bandaging and tamponade hemostasis methods.
2.3 Emergency treatment for shock
Mainly hemorrhagic or traumatic shock. After shock occurs, the lower limbs should be raised, blood volume should be replenished as soon as possible, respiratory tract should be kept unobstructed, and oxygen and pain should be given.
2.4 Emergency treatment for traumatic brain injury
Patients with traumatic brain injury should rest in bed and closely observe their consciousness, pulse, breathing, blood pressure, and changes in pupils. If cerebrospinal fluid leaks out of the nostrils or external auditory canal, it is forbidden to perform ear or nasal stuffing or flushing to avoid intracranial infection.
3、 Summary: The oral cavity, outer side of the eye socket, lips, and chin in the maxillofacial region have abundant blood vessels and dense nerves. After injury, pain is obvious and secondary infections are prone to occur. Early treatment should be sought when injury occurs. Especially oral and maxillofacial injuries that directly affect people's daily lives, especially their eating habits and appearance, should be taken seriously.