Assessment and Management of Face Wounds 
The face is very richly supplied with blood vessels. Therefore, injuries to the 
face are likely to have profuse bleeding and hemorrhage will be difficult to 
control. Because facial injuries may be quite disfiguring, the medical 
specialist may apply dressings to these wounds first, forgetting the priorities 
of treatment. Facial wounds are life-threatening only when the airway is 
obstructed or there is massive bleeding. 
I. Treatment for Face Wounds 
1. Assure an adequate airway and immobilize c-spine - An adequate airway and 
massive bleeding are the only immediate concerns when treating a person with 
facial wounds. Maxillofacial trauma, not associated with an airway obstruction 
or major bleeding, should be treated after the patient is stabilized completely 
and all life-threatening injuries have been addressed. Patients with 
maxillofacial trauma should be presumed to have an unstable c-spine injury and 
the neck should be immobilized. 
1. Clear the mouth of blood, mucous, broken teeth, detached bone fragments, 
removable dentures and other foreign material. If the patient is unconscious, 
the base of the tongue may rest in the back of the throat and block the larynx. 
a. Clear this type of obstruction by using manual maneuvers. If the patient is 
unconscious place an oral- pharynx or endotracheal tube if available.
b. When opening the airway, avoid hyperextension of the neck, due to possible 
c-spine fracture. 
2. Place the patient in a comfortable sitting position - Tilt his head slightly 
forward to drain blood and mucous out of the mouth. DO NOT use the sitting 
position if: 
a. It would be harmful to the patient because of other injuries.
b. The patient is unconscious, in which case, place him in the coma position. If 
there is a suspected c-spine injury, immobilize the head before turning the 
patient on his side. 
3. Apply a sterile dressing to the wound - to be demonstrated in class 
a. Use direct pressure to help control the bleeding. The conscious patient or an 
assistant can hold it in place. Place a pressure dressing over face, under chin 
and tied on side of face with knot over wound.
b. If there is a protruding injury from the mouth that is obstructing the 
airway, remove the object before trying to control the bleeding. This is the 
only time that an impaled object will be removed outside an MTF. 
4. Record the results 
It is good to recommend the casualty to a dentist or oral surgeon in many cases. 

5. Vitals/Evacuate casualty 
Training and Evaluation Outline 
CONDITIONS 
Given a patient who has a maxillofacial wound. The casualty is breathing. A 
canteen of water and the casualty's first-aid packet are available. 
STANDARDS 
Stop the bleeding and apply a dressing to the wound following the correct 
sequence without causing further injury to the casualty. Make sure that the 
casualty is properly positioned and that the dressing is secure. 
TRAINING/EVALUATION 
Evaluation Preparation 
Setup: Coach another student on how to respond as the patient. 
Brief soldier: Tell the medic to perform or describe the correct procedure to 
assess and manage a maxillofacial trauma. 
Evaluation Guide 
Performance Measures                                                             
    Results 
1. Assesses the trauma                                                           
         P     F 
2. Manages the trauma                                                            
                 
a. ABC's
b. clears mouth of blood, mucous and broken teeth                              P 
   F
c. has casualty in sitting or coma position                                      
        P    F
d. dresses the wound with sterile dressing                                       
      P    F 
3. Records the results and refers to dentist                                    
P     F 



[ Base Camp | The Big Adrenaline Rush! | Costa Rica | Costs and Departure Dates 
| E-mail | 
Wilderness First Aid | Survival Trekking© the Osa Peninsula | Terms and 
Conditions | Reservations ]