Multiple Facial Injuries due to Explosion of Firecracker in the Mouth: Life Threatening Complication and Emergency Airway Management

ABSTRACT

Most facial injuries are not life threatening and are superseded in priority by associated injuries. However, airway establishment may be difficult to achieve in patients with severe facial injuries. We report on a case of multiple facial injuries due to explosion of a firecracker in the mouth. A 15-year-old male patient was admitted to an emergency medical center with complaints of pain and bleeding in his oral cavity and dyspnea. Obstructed upper airway noises, the presence of multiple lacerations in the oral cavity, and massive oronasal bleeding were observed on physical examination. Direct rhinopharyngoscopy and neck Computerized tomography (CT) for evaluation of upper airway injuries were attempted, but failed. Emergency tracheostomy were able to perform and we could try neck CT for evaluation. The patient underwent plastic surgery and was discharged without complications after 25 days. This case represents a previously unreported cause of multiple facial injuries, and we discuss emergency airway management. Careful airway management resulted in a good outcome for this patient.