FIRST AID

in MAXILLOFACIAL INJURIES

Prof. MUDr. Peter Stanko, PhD.

 Rule „A, B, C, D“
• A .................................Airways

• B .................................Bleeding

• C .................................cardial action
/..............................Cervical spine

• D .......................................Drugs
 KEEPING FREE ARWAYS

●Keeping free airways

- above and under vocal cords

●Opening airways

- under vocal cords

Hippocrates maneuver

Stabilized position for transport

AIRWAYS – oral, nasal
Ambuvac O2 pump
Endotracheal intubation
– OTI – NTI
Trigonum omotracheale
(musculare)
LARYNX - cartilages
CONIOTOMY
Glandula

thyreoidea
Sagittal crosscut of the neck
 BLEEDING CONTROLE
IN MAXILLOFACIAL INJURIES

- Bones

- Soft tissues

- Combined injuries
Pressure points

• A. temporalis superf.

• A. facialis

• A. carotis
Ligatures of vesels
• Trigonum caroticum
(a. carotis externa)

A. lingualis:

• Trigonum Pirogovi
• Beclardov uhol
Anterior nasal tamponade
Posterior nasal tamponade

(Beloque)

• (Beloque)
Baloon nasal
tamponada
A. maxillaris
 Injuries of cervical spine
in maxillofacial trauma

►Fractures of vertebrae (C1 – C7)

►Injuries of intervertebral ligaments

...DAMAGE OF SPINAL
CORD (medula spinalis) !!!
FRACTURAE VERTEBRARUM (WATSON-JONES)

a – simple flection
a b b – hyperflection
c – compression
d – hyperextension

c d
WHIPLASH INJURY
WHIPLASH INJURY
 HYPEREXTENSION MECHANISM
OF INJURY OF CERVICAL CORD BY FALL

Medulla
spinalism
FACTORS BY DEVELOPMENT
OF NEUROLOGICAL DEFICIT

• Degree of injury of cervical spine

(distorsion, luxation, fracture)
• Diameter of canalis vertebralis
(inborn quality)
 IMMOBILIZATION
OF CERVICAL SPINE
•A./ Bandages „Schanzov límec“
- improvisional
- prefabricated (from molitan, hard etc.)
•B./ Surgical methods
- convetional tractions (Glisson´s swing) and
corset from plaster of Paris (Minerva)
- other tractions (Crutchfield, „halo“ system)
- spondylodesis (anterior laminectomy ? for
decompression)
RULE for treatment of pacients
with maxillofacial injury :

„ Considere every patient as he/she would

be with injury of cervical spine (not only
with suspection) like primary damaged in the
cervical region
and take in account possibility of secondary
damage till the definitive exclusion of it.“
Thank you for attention!