Nisreen Hamza M Maghraby* and François de Champlain
Department of Emergency Medicine, McGill University, CanadaFulltext PDF
Facial trauma from blunt injury is a common presentation that usually does not require specific emergency intervention. On the other hand, penetrating facial injuries can be quite challenging, as they may compromise airway integrity or, in rare cases, lead to life threatening massive bleeding if not controlled.To our knowledge there are no guidelines or recommendations on how to approach such challenging situations.In this case we present a patient with an initially stable deep facial injury that suddenly deteriorated requiring massive transfusion resuscitation and operative intervention. The situation was complicated by the presence of a Foreign Body (FB), which limited the amount of pressure that could be applied.Given the above, we reviewed the available literature on massive traumatic facial bleeding for possible alternative approaches to such a situation. Our findings can be summarized in a stepwise approach as follows: pressure, nasal packing, surgical ligation, and selective embolization of the external carotid artery or its branches.
Penetrating facial trauma; Bleeding facial laceration; Massive bleeding; Novel oral anticoagulant
Maghraby NHM, de Champlain F. Massive Facial Bleeding with an Implanted Orbital Penetrating Foreign Body in an Elderly Patient on a Novel Oral Anticoagulant. Ann Clin Case Rep. 2019; 4: 1672.