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KMID : 1144020160120010020
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Journal of Korean Association for Disability and Oral Health
2016 Volume.12 No. 1 p.20 ~ p.26
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ORAL HEMORRHAGE CONTROL AS TREATMENT PRIORITY IN MENTALLY RETARDED PATIENT WITH MULTIPLE TRAUMA
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Oh Ji-Hyeon
Kim Ji-Hun
Yoo Jae-Ha
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Abstract
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Sympathetic reaction to grotesque facial injuries with oral bleeding can trigger confusion and generate inefficiency among emergency room personnel. Regardless of the extent of the injury, or of the sympathy elicated, the victim must be evaluated and treated as a whole patient with multiple trauma. There must be no confusion as to order of importance in the steps of evaluation : 1. airway 2. hemorrhage 3. shock 4. associated injuries 5. local injury 6. triage of facial injuries.
The most dangerous aspect of oral hemorrhage is the possibility of its obstructing the upper airway. Swallowing large amounts of blood will usually cause gastric irritation and lead to vomiting, thus further complicating the management of the patient. Once a clear airway is assured and hemorrhage have been controlled, consideration is given to possible associated injuries before undertaking treatment of the facial injuries themselves. Status of the cardiopulmonary, gastrointestinal and neuromuscular systems all have a bearing on decisions concerning facial injury treatment.
In this light, treatment priority becomes exceeding important. On the other hand, the importance of facial injuries should never be minimized, especially in a mentally retarded patient with oral hemorrhage. This is a case report about oral hemorrhage control as treatment priority in a mentally retarded patient.
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KEYWORD
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Compound jaw fracture, Multiple trauma, Oral hemorrhage, Transpalatal wiring, Treatment priority
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