Flow Charts and Checklists

3 Flow Charts and Checklists

Initial Management

image See p. 2.

 

Table 3.1 Checklist for initial management

Objective

Measure

Establish and maintain airways (intubation, cricothyrotomy, tracheotomy)

Clearing the upper airways of discharge or prolapsed tongue (combination fractures of mandible and maxilla), dentures

Stabilize circulation

Establishing intravenous access, monitoring, fluid resuscitation

Exclude intracerebral pressure, intracranial hematoma, brain swelling

Neurologic status, CT, possibly intracranial pressure (ICP) catheter, decompression, hematoma evacuation

Exclude internal bleeding

Thoracic trauma: CT, drainage if necessary

Abdominal trauma: ultrasonography, CT, or peritoneal lavage, laparotomy if necessary

Pericardial packing: ECG, echo-cardiogram, pericardiocentesis

Exclude paraplegia and compartment syndrome

Neurologic status, CT, decompression and stabilization of the spine if necessary

Clinical signs, sensation, motor response, fasciotomy if necessary, fracture reduction, osteosynthesis

Soft tissue injuries

Wound management

Initial Evaluation

Table 3.2 Checklist for initial evaluation

Patient history

Loss of consciousness, vomiting

Impaired nasal breathing, loss of olfactory/taste sensation, impaired vision, sensory disturbance

Inspection and palpation

Hemorrhage, open wounds, foreign bodies

Cerebrospinal fluid or brain matter leak

Swelling, hematoma, air crepitus

Osseous step-offs, osseous gaps, abnormal mobility

Functional testing

Visual function

Taste sensation/olfactory function

Sensory assessment

Diagnostic imaging

CT, a.-p. cranial views, lateral cranial views

Immediate care

Extruding brain matter, intracerebral hemorrhage, intracerebral pressure, vision loss

Interval treatment

Cerebrospinal fluid leak, pneumocephalus

– Orbit and globe

Pupil width and reaction, gross evaluation of vision, globe position, motility, diplopia

Diagnostic imaging

Radiologic evaluation of the paranasal sinuses, compare zygomatic arches, OPG, Clementschitsch, CT

Immediate care

Replantation of teeth

Management of open fractures

Interval treatment

Craniofacial reduction and reconstruction

Injuries of the Neurocranium

image Diagnosing Injuries of the Neurocranium, Chapter 5, p. 38.

image Treatment of Injuries of the Neurocranium, Chapter 16, p. 137.

image

Fig. 3.1 Flow chart for acute head injury.

Injuries of the Skull Base

image Diagnosing Injuries of the Skull Base, Chapter 6, p. 45.

image Treatment of Injuries of the Skull Base, Chapter 17, p. 140.

image

Fig. 3.2 Flow chart for injuries of the skull base.

Injures of the Ear and Lateral Skull Base

image Diagnosing Injuries of the Ear, Chapter 7, p. 53.

image Treatment of Injuries of the Ear, Chapter 18, p. 147.

image

Fig. 3.3 Flow chart for injuries of the ear.

 

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Aug 21, 2016 | Posted by in HEAD AND NECK SURGERY | Comments Off on Flow Charts and Checklists

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Table 3.3 Checklist for injuries of the ear and lateral skull base

Patient medical history