다발성 손상을 가진 정신지체 환자에서 치료 우선순위로 구강출혈의 조절
ORAL HEMORRHAGE CONTROL AS TREATMENT PRIORITY IN MENTALLY RETARDED PATIENT WITH MULTIPLE TRAUMA
오지현, 김지훈, 유재하,
소속 상세정보
오지현 ( Oh Ji-Hyeon ) - 연세대학교 원주세브란스기독병원 치과학교실
김지훈 ( Kim Ji-Hun ) - 연세대학교 원주세브란스기독병원 치과학교실
유재하 ( Yoo Jae-Ha ) - 연세대학교 원주세브란스기독병원 치과학교실
KMID : 1144020160120010020
Abstract
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.
키워드
Compound jaw fracture; Multiple trauma; Oral hemorrhage; Transpalatal wiring; Treatment priority
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