Emergency War Surgery NATO Handbook: Part IV: Regional Wounds and Injuries: Chapter XXIII: Maxillofacial Wounds and Injuries

Respiratory Obstruction

United States Department of Defense

Respiratory obstruction in a patient with maxillofacial injuries may be due to several causes, as follows:

1. Blockage of the airway by accumulated blood and secretions or by loose objects, such as broken teeth or dentures.

2. Prolapse of the tongue, which occurs frequently with injuries, especially when acute avulsion of the mandibular symphysis has occurred.

3. Injuries of the hyoid bone and its attached muscles, with resulting loss of control of the tongue-hyoid complex.

4. Swelling of the tongue and soft palate.

5. Laryngeal spasm, which may be caused by anesthetic agents.

No time should be lost in reversing hypoxia, which can rapidly progress to death. The patient is positioned to permit drainage by gravity, and the airway is rapidly cleared of blood, secretions, foreign bodies, or whatever else may be blocking it. Direct vision and strong suction are necessary. In the event that these non-invasive maneuvers fail to immediately relieve obstruction, there must be no hesitancy to perform endotracheal intubation or cricothyroidotomy. In certain laryngotracheal crush injuries and other wounds which transect the trachea, it may be necessary to perform emergency tracheostomy. Cervical spine in-line control must be maintained during these maneuvers.  

Approved for public release; Distribution is unlimited.

The listing of any non-Federal product in this CD is not an endorsement of the product itself, but simply an acknowledgement of the source. 

Operational Medicine 2001

Health Care in Military Settings

This web version is provided by The Brookside Associates Medical Education Division.  It contains original contents from the official US Navy NAVMED P-5139, but has been reformatted for web access and includes advertising and links that were not present in the original version. This web version has not been approved by the Department of the Navy or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. The Brookside Associates is a private organization, not affiliated with the United States Department of Defense.

Contact Us  ·  ·  Other Brookside Products