Maxillofacial trauma airway management

Model answer

Framing. Maxillofacial trauma is a shared-airway emergency: assess for impending obstruction (swelling, haematoma, bilateral mandible, midface instability), clear blood and foreign material, maintain C-spine precautions, choose awake techniques or RSI with video laryngoscopy and a double set-up for front-of-neck access, avoid blind nasal routes when midface/base-of-skull injury is possible, and plan extubation carefully after swelling assessment.^[1]

Must cover.

• Airway threats by fracture pattern (Le Fort, mandible, panfacial)
• Decision for early intubation vs observation
• Awake FOI / VL / surgical airway readiness
• C-spine and full stomach considerations
• Nasotracheal tube contraindications
• Haemorrhage control and packing interaction with airway
• Extubation criteria after facial surgery
• Communication with maxillofacial surgeon (wiring, IMF)

Crisis. Cannot intubate / cannot oxygenate with facial trauma and progressive swelling — declare CICO and proceed along the failed-intubation algorithm.^[1]

High-yield numbers/facts. Include exact taught figures where relevant (airway-assessment scores; CICO decision points; surgical-airway indications without inventing unverified timings).^[1]