|
Trauma Protocol |
|
For those cases admitted: 1. Ensure that patient is fully resuscitated. Be aware of potential airway problems in fracture of the middle third of the facial skeleton. Examine the exclude the presence of associated injuries, eg skull fractures. 2. Radiographs as indicated by site of injury or clinical suspicion of fracture. Impressions for custom made arch bars if indicated. 3. Make clear record in notes of maxillofacial injuries and record nerve damage accurately pre-operatively. 4. Suture primarily all lacerations to the facial area under local anaesthesia if possible. They can be revised later if necessary. 5. Drugs - ¨ Cefuroxime/ Metronidazole or Augmentin iv pre-operatively ¨ Corsodyl m/w ¨ Diclofenac 100mg pr 18 hourly ¨ Avoid opioids if possible 6. IV fluids if theatre imminent or if patient unable to take fluids orally 7. TTAs—Antibiotics for 5 days, Corsodyl and Analgesia 8. Radiographs—PA Mandible/ OPG for fractured mandibles, OMs for middle third fractures 9. Dietician if IMF or firm elastics applied.
|
|
Most but not all fractures need to be admitted. Undisplaced fractures or minimally displaced zygomas for example may be reviewed in out-patients. Be sure to inform out-patients reception staff and Sister of cases you organize to review in out-patient clinics. |
