You are treating an Airman who has sustained face and mouth injuries from a HMMWVa?

Primary Survey (ABCs):

- Ensure patency of airway and cervical spine stability.

- If the airway is obstructed, initiate jaw thrust or chin lift while maintaining cervical spine stability.

- If the airway remains obstructed, perform a cricothyroidotomy.

- Provide supplemental oxygen via nonrebreather mask.

- Assess breathing and initiate positive pressure ventilation if needed.

- Assess circulation and control any severe bleeding.

- Start two large bore IVs and infuse with warmed IV fluid.

Secondary Survey:

- Assess the extent facial injuries and inspect the mouth for any foreign objects, loose or fractured teeth.

- Immobilize the cervical spine until a cervical spine x-ray is obtained and cleared.

- Perform a detailed neurological assessment, including Glasgow Coma Scale (GCS), pupillary reaction, and motor and sensory function.

Tertiary Survey:

- Obtain complete medical history and mechanism of injury.

- Perform a thorough physical examination, including careful examination of the face, mouth, and neck.

- Order appropriate radiological investigations, including facial x-rays, panorex (dental x-ray), and/or CT scans as needed.

- Consult with maxillofacial and dental surgeons for management of facial injuries and dental repairs, as well as any specialist opinion regarding neurological/ ophthalmological damage due to the accident.

Definitive Care:

- Manage pain with analgesics.

- Administer antibiotics as indicated to prevent infection.

- Perform surgical repair of facial injuries under the supervision of a maxillofacial surgeon as needed.

- Provide support and counseling as required.