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Maxillofacial Injury—Not Always a Difficult Airway

Published online by Cambridge University Press:  21 May 2015

John Glasheen ,
David Hennelly  and
Stephen Cusack
John Glasheen*
Affiliation:
Emergency Department, Cork University Hospital, Cork, Ireland
David Hennelly
Affiliation:
Clinical Development, National Ambulance Service, Limerick, Ireland
Stephen Cusack
Affiliation:
Emergency Department, Cork University Hospital, Cork, Ireland
*
Correspondence: John Glasheen, MB, BCh, BAO, MScEMS Emergency Department Cork University Hospital Cork, Ireland E-mail: Jglash@hotmail.com
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Abstract

The optimal method for securing the airway in injured patients is controversial. Maxillofacial injury has been shown to be a marker for difficult airway management; however, a delay in intubation may result in deterioration of intubating conditions due to further airway bleeding and swelling. Decisions on the timing and method of airway management depend on multiple factors, including patient characteristics, the skill set of the clinicians, and logistical considerations. This report describes the case of a multi-agency response to a motor-vehicle collision in a rural area in Ireland. One young male patient had sustained significant maxillofacial injuries, multiple limb injuries, and had a decreased level of consciousness. Further airway compromise occurred following extrication. Difficult intubation was predicted; however, abnormal jaw mobility from bilateral mandibular fractures enabled easy laryngoscopy and intubation. Although preparation must be made for difficult airway management in the setting of maxillofacial injury, appropriately trained and experienced practitioners should not be deterred from performing early intubation when indicated.

Glasheen J, Hennelly D, Cusack S. Maxillofacial Injury—Not Always a Difficult Airway. Prehosp Disaster Med. 2015;30(4):1 –4.

Keywords

maxillofacialprehospital caretrauma
Type
Case Report
Information
Prehospital and Disaster Medicine , Volume 30 , Issue 4 , August 2015 , pp. 421 - 424
Copyright
© World Association for Disaster and Emergency Medicine 2015 

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