2 Examining the Patient Standardized evaluation procedures for all organ systems of the head and neck should be followed for every patient presenting with head trauma. Systematic evaluation minimizes the risk of overlooking any aspect of injury. Determining the mechanism of injury is paramount (e. g., see Table 2.1). If the patient is unconscious or unable to answer questions, witnesses to the accident, prehospital emergency care providers, and relatives should be interviewed. It is important to know the direct mechanism of injury as well as other factors (helmet, seatbelt, etc). Knowing the patient’s prior health status is vital. Special consideration should be given to: Thorough documentation of patient history is also essential for follow-up insurance questions. Photo documentation is advisable.
Patient History
pre-existing conditions;
previous operations;
infectious diseases (hepatitis, HIV);
immunization status (tetanus, rabies for animal bites).
Type of injury | Diagnosis | Treatment |
Cut | ||
Bite | ||
Missile wound | ||
Burn | ||
Chemical/alkali burn |
Inspection
Inspection involves assessing external injuries such as bruising, hematomas, and wounds. Even apparently insignificant injuries can be critical:
hemorrhage (
wounds (Diagnosis, Chapter 4, p. 27; Treatment, Chapter 15, p. 130);
foreign bodies;
hematomas.
Palpation
Palpation should always be carried out using a systematic approach (Fig. 2.1a). The aim of palpation is to detect swelling, hematomas, crepitus, and abnormal mobility. Palpation should be conducted bilaterally, using both hands.
Neck
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
