Respiratory compromise can have a delayed onset if certain conditions are present. It is important to constantly monitor the athlete and to look for signs of respiratory obstruction.
Patient selection: athlete with head and neck trauma
Conditions associated with delayed respiratory compromise:
(1) bilateral fractures of the anterior mandible (which may be associated with posterior prolapse of the tongue base)
(2) Le Fort fracture of the maxilla (with obstruction of the nasopharynx and/or hemorrhage)
(3) foreign body (mouth guard, teeth, bone fragments, debris)
(4) soft tissue swelling within the oropharynx and larynx (which may be heralded by a worsening inspiratory wheeze)
(5) trismus (decreased mouth opening) AND (hemorrhage or oropharyngeal swelling)
where:
• Blindly sweeping the oropharynx with a finger can push a foreign body deeper, worsening an obstruction.
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