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16 Cards in this Set

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What are the six preventive measures patients/parents can take to prevent trauma injuries?
1. Community Education
2. Safe play environment
3. Helmets
4. Mouthguards
5. Dental first aid measures
6. Availability of appropriate care.
What are the patient/parent characteristics after dental trauma has occured?
1. Child frightened, likely first dental experience if <3.5 years
2. Parent upset
3. Dentist confidence critical to success.
Name 5 ways to defuse parent apprehension during dental trauma.
1. Appear confident and calm.
2. Emphasize frequency of pediatric injuries.
3. State behavioral expectations.
4. Work expediently
5. Maintain communication.
What 5 items should be covered concerning informed consent?
1. Injuries can lead to insurance and legal claims.
2. Be prepared to submit dental record.
3. Keep current!
4. Explain range of outcomes.
5. Be clear about costs/time involved.
What should be included in the medical history for a trauma patient?
1. Name of physician
2. General Health (Cardiac and Bleeding disorders,Seizures)
3. Allergies
4. Medications
5. Tetnas immunization status (unimmunized child needs immunization or antitoxin.
6.Previous dental trauma
7.Specifics of accident (When, Where, how the accident occurred)Was it observed?
8.Are there signs of serious medical problems?
9.Tx prior to arrival in dental office.
10.Rule out child abuse.
What triage should occur with dental trauma?
1. Dental trauma is a subset of head trauma.
2. Is this a true medical emergency?
Is cervical spine injury a true medical emergency?
Yes. Should be included in triage for dental trauma. Very rare in children. Occurs mostly in MVA in older patients (>40)
How many C-spine injuries in 301 pediatric patients with 565 facial fx?
None
What are the three most common presentations (signs and symptoms) of intracranial injury?
1. Asymptomatic
2. Vomiting
3. Headache
What are the nine symptoms associated with intracranial injury?
1. Loss of consciousness > 30 seconds
2. Prolonged or worsening headache.
3. Persistent drowsiness
4. Abnormal mental status-Glasgow Coma Scale
5. Focal neurological signs (Numbness and Blurred vision)
6. Repeated vomiting
7. Non impact seizure
8. Signs of skull fx in temporopariental or occipital area.
9. Signs of depressed or of basal skull fx.
What are symptoms not associated with intracranial injury?
1. Temporary headache
2. Vomiting
3. Loss of Consciousness < 30 seconds
4. Impact seizure
Triage Exam: Orient x 3
1. What is your name?
2. What place is this?
3. Is it morning, afternoon or nighttime?
Triage Exam: Visual
1. Blood or clear fluid from ear to nose? (Possible CSF leak from skull fx or LeFort II or III fx)
2. Subdural hematoma
3. Result of impact injury or blunt head trauma. (Altered LOC, Protracted vomiting, Irritability, Seizure)
4.Battle Sign-Bruising behind the ear. (Result of basilar skull fracture and bleeding into mastoid air cells)
5. Vital signs- slow pulse + elevated blood pressure is a sign of increased intracranial pressure.
Cranial Nerve III Exam
PERRLA: Pupils equal, round, responsive to light, and accomodate.
(Watch for pupil that doesn't constrict and/or eyelid ptosis)
Cranial Nerve III, IV, VI Exam
EOMI: Extraocular movements intact.
(Watch for inability to track finger moving laterally and vertically)
Cranial Nerve VII Exam
Patient closes eyes, smiles, and frowns.
(Watch for asymmetry)