631 Designing an Oral and Maxillofacial Trauma Assessment Proforma for Dental Core Trainees in Northern Ireland

Aim The dental core training (DCT) scheme is an optional postgraduate training pathway for dental graduates who have completed their foundation training and wish to undergo further specialist training. The majority of posts available in Northern Ireland (NI) are within oral and maxillofacial surgery (OMFS) units and include on-call commitment. Dental core trainees (DCTs) are expected to examine and assess OMFS trauma patients and often have limited experience of this prior to post commencement. This project outlines the development of an OMFS trauma assessment proforma designed for DCTs working in NI. Method An initial OMFS trauma proforma was designed alongside senior staff. This was introduced to 6 DCTs and 2 trust SHOs within a tertiary OMFS unit. 34 proformas were recorded within month 1, following which a feedback survey was completed by the 8 trainees. A revised proforma was redistributed and 33 recorded over month 2, followed by a repeat feedback survey. Results The revised proforma was found to be successful amongst trainees within the unit to act as an aid memoir and provide systematic structure to trauma examination. 100% of trainees recorded the revised proforma as useful. As a result, the proforma was introduced as part of the national induction programme for new DCTs commencing training posts in NI. Conclusions Progressing from general practice dentistry to the role of an OMFS DCT can be a challenging transition for many trainees. The proforma aids to guide junior clinicians in how to structure and record oral and maxillofacial trauma whilst ensuring thorough and comprehensive examination.

Traumatic Bilateral Self-Enucleation With Subarachnoid Hemorrhage

We present a rare case of traumatic self-enucleation of the bilateral globes resulting in traumatic subarachnoid and intraventricular hemorrhages. This case highlights the critical importance of multidisciplinary trauma care, starting with recognition of the potential for less obvious injuries such as contralateral optic nerve injury in unilateral enucleation, intracranial hemorrhage, and cerebrovascular injuries. We highlight the role of a thorough trauma assessment and workup, especially in the context of highly distracting injuries in patients who may also have severe mental illness. The trauma and acute care surgeon, who also serves as the critical care specialist, should be well prepared to facilitate care between multiple subspecialists including neurosurgeons, interventional radiologists, vascular surgeons, and psychiatrists, with a high index of suspicion for occult trauma in seemingly isolated injuries.

Airway Trauma: Assessment and Management

Recognizing airway trauma and safety management is challenging for any anaesthesiologist. Many types of airway injuries require identifying airway anatomy correctly; early assessment and proper management are crucial for saving many lives. Proper management involves the classification of those patients into three categories. Each one has a unique and different control. Knowing your capabilities and skills are very important for safe airway management. It does not matter where you are but skills, knowledge of airway management algorithms and tools you have. After reading this book chapter, the participant will be able to define airway trauma, proper airway risk assessment and safety management.