Resident Manual of Trauma to the Face, Head and Neck

y y Odynophagia, dysphagia, decreased oral intake, vomiting. y y Ptyalism. y y Hemoptysis, hematemesis. y y Neck pain. 3. Information Gathering a. Foreign Body It is important to gather information about the foreign body: y y Size. y y Shape. y y Material. y y When the aspiration or ingestion occurred. b. History of Similar Episodes A history of similar episodes is also important. Recurrent episodes suggest the need for further work-up to rule out an underlying neuro- logic or anatomic abnormality. c. Last Oral Intake It is important to know when the patient last ate or drank. d. Complete Patient History y y Medical history. y y Surgical history. y y Medications. y y Allergies. y y Social history. C. Physical Evaluation 1. General Check the patient’s vital signs, alertness, and interactivity. 2. Head, Eyes, Ears, Nose, and Throat Evaluate HEENT for the following: y y Airway —Stridor, stertor, nasal flaring, retractions. y y Voice —Hoarse, breathy, muffled. y y Oral cavity/oropharynx —Dentition, lacerations/abrasions, foreign body. y y Neck —Crepitus, mobility, palpable thud over trachea or audible slap sometimes appreciated with tracheal foreign bodies. 3. Pulmonary Check for retractions, wheezing, or diminished breath.

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