Emergency Department Management of Maxillofacial Trauma - Trauma EXTRA Supplement (Trauma CME)

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Delivery Method:	Online
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Publication Date: October 2024 (Volume 26, Supplement 10)

CME Credits: 4 AMA PRA Category 1 Credits™, 4 ACEP Category I credits, 4 AAFP Prescribed credits, and 4 AOA Category 2-B CME credits. CME expires 10/15/2027.

Specialty CME Credits:Included as part of the 4 credits, this CME activity is eligible for 4 Trauma credits, subject to your state and institutional approval.

Author

Peer Reviewers

Abstract

Patients with maxillofacial trauma require careful evaluation due to the anatomical proximity of the maxillofacial region to the head and neck. Facial trauma can lead to life-threatening airway compromise or hemorrhage, or permanent facial deformity. Although the Advanced Trauma Life Support guidelines provide a framework for the management of trauma patients, they do not provide a detailed reference for many subtle or complex facial injuries. In addition to an overview of maxillofacial trauma pathophysiology, associated injuries, and physical examination, this review will also discuss relevant imaging, treatment, and disposition plans.

Case Presentations

A 27-year-old man presents to the ED after a high-speed motorcycle accident...

• He was not wearing a helmet.
• His GCS is 7 on arrival and he is not protecting his airway. You note significant facial trauma and his midface is unstable.
• He has a cervical spinal collar in place.
• As your team gets intubation equipment ready, you consider what might be the best way to manage this patient’s airway.

A 75-year-old-woman is brought to the ED after a mechanical fall...

• She has epistaxis and a visible deformity of her nasal bridge.
• As you hold pressure to control the bleeding, you consider if you should obtain imaging and how to manage her injuries.

An inebriated man who was punched multiple times in the face in an altercation presents to the ED...

• He has significant periorbital swelling around his left eye and a deformity of the jaw.
• After ordering a CT, you wonder if you need to obtain surgical consultation.

Accreditation:

EB Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.