Before completing a detailed history and physical evaluation of the facial area, critical injuries that may be life threatening must be addressed. The first stein evaluar ing a trauma patient is to assess the patient’scardiopular,stability by ensuring that the patient has a patent airway andis adequately ventilated. Vital signs, including respiratory and pulse rates and blood pressure, should be taken and recorded; During this initial assessment (i.e., primary survey), other potentially life-threatening problems, such as excessive bleeding, should also be addressed. .Immediate measures, such as pressure dressings, packing, and clamping of briskly bleeding vessels, should be accomplished as quickly as possible. An assessment of the patient’s neurologic status and an evaluation of the cervical spine should be completed next. ‘forces severe
enough to cause fractures of the facial skeleton are often transmitted to the cervical spine. T11e neck “Should be temporarily immobilized until neck injuries have been ruled out. Careful palpatio of the neck to assess ssiblc
areas of tenderness and a cervical spine radiographic Series should becompleted as soon as possible.
Simply grasping, repositioning and stabilizing the mandible into a more anterior position may alleviate this obstruction. Placement of a nasopharyngeal or an oropharyngeal airway may also be sufficient to temporarily maintain a patent airway. In some cases, endotracheal.
intubation may be necessary. Any prosthetic. devices, avulsed teeth, pieces of completely avulsed bone, or other
debris may; also contribute to airwav occlusion and must he removed immediately, .-\ny areas of bleeding should be quickly examined and managed with packing, pressure , dressings, or clamping .. -\11 excess saliva and blood must, be suctioned from the pharynx to avoid aspiration and laryngospasm.