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Case 6: Crush Injury Face

Dear Readers I hope this is not too gory for you because I had not seen a real eyeball popping out of its socket in somebody alive. Let me tell you what happened that day…There was a call from casualty that a Facial trauma patient needs urgent attention and also that it was so bad that one of the casualty nurses had fainted on seeing this patient. I had just finished examining a patient in OPD and rushed immediately to Casualty department. On first sight it seemed like a miracle that this man was alive even after sustaining such a grievous injury. But we as MaxFacs have read about these survivors of severe Faciomaxillary injuries in trauma textbooks, but actually treating one is a different game altogether. This chap was driving a tractor to his field when the tractor toppled and his face got crushed beneath it…pheww!!

I followed the basic ATLS principles (ABCDE) starting with the airway and Tracheostomy was done along with primary intraoral suturing to control bleeding. Patient had already lost lots of blood so two packed cells were transfused while suturing was done. He was then shifted to radiology for CT scan of face so that definite treatment could be planned.