Emergency bleeding control in a mentally retarded patient with active oral and maxillofacial bleeding injuries: report of a case.
10.5125/jkaoms.2010.36.4.303
- Author:
Dong Yub MO
1
;
Jae Ha YOO
;
Byung Ho CHOI
;
Sung Han SUL
;
Ha Rang KIM
;
Chun Ui LEE
Author Information
1. Department of Oral and Maxillofacial Surgery, Wonju Christian Hospital, College of Dentistry, Yonsei University, Wonju, Korea. metalblack@hanmail.net
- Publication Type:Case Report
- Keywords:
Active oral hemorrhage;
Shock;
Mentally disabled patient;
Wound drainage;
Emergency hemorrhage control
- MeSH:
Adult;
Airway Obstruction;
Blood Platelets;
Cerebral Palsy;
Drainage;
Emergencies;
Glycosaminoglycans;
Hemorrhage;
Humans;
Hydrocarbons, Iodinated;
Infection Control;
Male;
Mentally Disabled Persons;
Purpura, Thrombocytopenic;
Rubber;
Scurvy;
Shock;
Sutures;
Wound Infection
- From:Journal of the Korean Association of Oral and Maxillofacial Surgeons
2010;36(4):303-308
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Excessive oral and maxillofacial bleeding causes upper airway obstruction, bronchotracheal and gastric aspiration and hypovolemic shock. Therefore, the rapid and correct bleeding control is very important for saving lives in the emergency room. Despite the conventional bleeding control methods of wiring (jaw fracture, wound suture and direct pressure), continuous bleeding can occur due to the presence of various bleeding disorders. There are five main causes for excessive bleeding disorders in the clinical phase; (1) vascular wall alteration (infection, scurvy etc.), (2) disorders of platelet function (3) thrombocytopenic purpura (4) inherited disorders of coagulation, and (5) acquired disorders of coagulation (liver disease, anticoagulant drug etc.). In particular, infections can alter the structure and function of the vascular wall to a point at which the patient may have a clinical bleeding problem due to vessel engorgement and erosion. Wound infection is a frequent cause of postoperative active bleeding. To prevent postoperative bleeding, early infection control using a wound suture with proper drainage establishment is very important, particularly in the active bleeding sites in a contaminated emergency room. This is a case report of a rational bleeding control method by rapid wiring, wound suture with drainage of a rubber strip & iodoform gauze and wet gauze packing, in a 26-year-old male cerebral palsy patient with active oral and maxillofacial bleeding injuries caused by a traffic accident.
