![]() ![]() The evaluation of patients with facial injuries. Consultation with a Maxillo-facial Service should be arranged early in Paediatric mortality in trauma is usually secondary to airway compromise or associated neurological injuries. While facial injuries in children are rarely fatal, they may have significant functional and cosmetic sequelae. Open wounds should be covered with moist, clean dressings and tetanus prophylaxis administered if required. Secondary surveyĪ detailed craniomaxillofacial examination should be performed during the secondary survey, after initial stabilization of the patient. Fiberoptic intubation may be necessary to control the airway of the pediatric trauma patient.Ī chest x-ray to exclude aspiration of dental fragments or foreign bodies may be indicated.Ie., the proper sized tube for a 4 year old child would be (16+4)/4 =5mm (internal diameter) A quick method for determining the proper size endotracheal tube includes adding 16 to the child's age in years, and dividing by 4.Concurrently, the cervical spine must be stabilized and protected until further assessment for cervical spinal injury is undertaken.Control of bleeding by local pressure and, if required, scalp sutures or staples as well as temporary reduction of fractures may be indicated immediately.Bleeding may be profuse (and occult) from scalp lacerations and fractures of the mid-face.Tongue-displacement secondary to comminuted anterior mandibular fractures may also compromise the airway.A softer and floppier epiglottis may complicate pediatric endotracheal intubation. ![]()
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