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Sun May 4 12:23:51 BST 2008

It would depend upon the wound, its entry point and also, if there is one,
the exit point - as well as the particular injuries caused.

With the limited information I have, the best solution is to pack the wound
with haemostatic soaked agents (e.g. QuickClot [granules, ACS+, First
response] or HemCon etc.) HemCon do special dental dressings for oral trauma
as well. Some of these products do have an exothermic reaction but some of
the newer versions don't tend to have this problem. Either way, if the
patient is bleeding to death, exothermic reaction is not your immediate
concern but rather haemorrhage control - but it can become a concern in
later definitive management of the injury.

Matthew

-----Original Message-----
From: Sa'ad Lahri [mailto:slahri at webmail.co.za] 
Sent: 03 May 2008 18:02
To: trauma-list at trauma.org
Subject: stab mouth

Hi

saw a 25 y old chap last night, stabbed in the mouth. had a large

dento-alveolar fracture, found him lying on floor in a pool of blood

my question is regarding haemostasis. i really struggled. tried adrenaline

soaked swabs, injected local with adrenaline, even did a few chromic

catgut sutures (all i had)

eventually had to get max fax involved. did not have chance yet to chat to

them but any advice would be great. what would you have done differently.

anybody with prior experience in handling these fractures?

Sa'ad

Dr Sa'ad Lahri

Emergency Medicine Registrar

UCT/US

Cape Town

South Africa

Tel: +27826642421

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