Injuries to the Face Skull 2018 Cogent Steps

Injuries to the Face & Skull © 2018 Cogent Steps, LLC

Considerations Common in sports Minor to life threatening Concussion Spine injury Complications Cranial nerve testing © 2018 Cogent Steps, LLC

Epidural Hematoma Tear in meningeal artery Quick accumulation of blood between skull and dura mater Skull fracture Lucid period Headache, dizziness, nausea/vomiting Dilated pupils Respiratory difficulty © 2018 Cogent Steps, LLC

Subdural Hematoma More common in sports Acceleration/deceleration force Acute or chronic Headaches, behavior changes LOC in 48 -72 hours © 2018 Cogent Steps, LLC

Skull Fracture Blunt trauma Palpation (Head-to-toe assessment) Bumps are better than indents No direct pressure Signs/Symptoms Headache, nausea/vomiting CSF Battle sign Raccoon eyes © 2018 Cogent Steps, LLC

Maxillofacial Injuries Common Dental guards / facial shields help Concussion / spine Control bleeding Consider skin closure techniques Oral examination Motor / sensory function Eye / vision © 2018 Cogent Steps, LLC

Nasal Fracture: - Epistaxis Pressure to stop bleeding Pack with care CSF Refer to ENT for care This Photo by Unknown Author is licensed under CC BY-NC-ND © 2018 Cogent Steps, LLC

Eye Injuries Eyewear and helmets matter Severity proportional to size and velocity Projectiles Globe ruptures Racquet sports Blowout fractures Baseball Hyphema Abrasions, contusions Retinal damage © 2018 Cogent Steps, LLC

Treatment & RTP Considerations - Remove contact lens Cover both eyes Eye / Face protection Visual field and reflexes Concerns for mononocular athletes - Collision sports This Photo by Unknown Author is licensed under CC BY-SA © 2018 Cogent Steps, LLC

Facial Exam Lab General observations: Top down approach Bleeding Facial asymmetries Missing teeth Look behind ears Functional tests: Raise eye brows Close and squint eyes Pucker lips Smile Say ahh, open/close mouth Tongue movements Breathe/test smell Test hearing (rubbing fingers) © 2018 Cogent Steps, LLC Palpation: Top down (pain, crepitus, asymmetry) Head/scalp Forehead Supraorbital rim Infraorbital rim Nasal septum Zygomatic arch Vision exam Light pen: pupil reactivity, pain, light sensitivity Tracking/Smooth pursuit (H pattern) Saccades (nose to finger) Read