The major concern in prehospital care is control of the airway. The mouth should be cleared of any foreign body or debris and suctioned of blood. The tongue may block the airway, and a jaw thrust or modified chin lift without neck extension often relieves the obstruction. With severe mandible fractures, these maneuvers may not elevate the tongue, necessitating manual extraction. As a rule, any patient with trauma above the clavicles should have the cervical spine immobilized.
If there is copious bleeding and massive facial injury, early notification allows the ED to prepare for a difficult airway. EMERGENCY MANAGEMENT: RESUSCITATION
The compelling and sometimes grotesque nature of facial injuries must not distract physicians from following the routine, sequential trauma protocol. The most urgent complication of facial trauma is not shock, but airway compromise, particularly with midfacial and lower facial trauma.
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