Extensive facial trauma after being ejected from the vehicle!
This is status post ejection due to a motor vehicle collision. Patient likely wasn’t wearing a seatbelt! There’s an obvious head injury.... What's your treatment plan? In virtually all circumstances, the chance of survival in a crash is much greater if the occupant is not ejected from the vehicle. Ejections often happen in high-speed accidents in which the velocity of the cars and the force of the collision are so strong that they throw people from the vehicle. This patient suffered from multiple facial bone fractures (including all mandible, midface, and orbit fractures) which, along with skull base trauma, can be a relatively serious and life-threatening injury. Furthermore, maxillofacial fractures have been associated with a high incidence of concomitant injuries, including ocular and intracranial injuries. In general, fractures may be treated by performing a closed reduction (resetting the broken bone or bones without surgery) or an open reduction (surgery that requires an incision to reposition the fractured bones). For a complex fracture with multiple broken bones, reconstructive surgery is required. Photo by @the_akrish
The 1st assessment for ABC of truma and call for help. Put iv fluids crystalloids or normal saline. Bleedings, wounds and fracturs need to be seen by CT scan for head , neck, chest and pelvis. Need for ICU and may be surgical intervention . 2nd assessment for deterioration and acceleration of intervention if needed . Consultations for General surgery, Maxillo facial, ENT, Neuro surgery and others accordingly.
What would be drug of choice here in this case for severe pain?
He is unconscious probably and intubated so he is sedated
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