А . Questions for self-checking:

1. Choose the method of emergency aid at asphyxia.

Dislocational	Removal of a foreign matter
Obturational	Fixation of tongue
Stenotic	Conicotomy, tracheotomy
Valvate	Suction of contents of respiratory ways
Aspirational	Fixation of flap by the tire

2. Choose the method of hemostasia

Temporal methods	Final methods
Digital occlusion of arthery	Ligation of vessel at wound
Coagulation of vessels	Tamponade of wound
Compressive bandage	underruning of vessel at wound
application of tourniquet at damages part of neck	underruning of vessel in trouth
Clipping of vessel at wound	Embolization by artificial trombus

B. Tasks for self-checking: 1. Patient, 20 y. had punch at mental area. He doesn’t lost his consciousness. General condition is normal. There is asymmetry of face, because of edema and hematoma of both submandible areas. There is strong pain at mandible at palpation. There is positive symptom of load at area of 44, 43 and 34, 35 teeth. Opening of moth is to 2 cm. There is wound of mucous membrane of oral cavity. Deformation of bite is present. What type of asphyxia is possible? (Answer: dislocational asphyxia).

2. Patient was getting at medical office of regiment with gunshot wound of soft tissues of lower part of face, fracture of mandible at mental area and dislocational asphyxia. What kind of treatment is useful to treat asphyxia. (Answer: fixation of tongue by pin at right position, reposition and fixation of bone fragments of mandible).

3. Patient was getting to hospital with industrial trauma. Trauma was getting one hour ago. There is evident histotripsy at right angle of moth, massive bleeding from oral cavity. There is deep lacerated wound at right lateral part of tongue 2,5-3 cm long. What is tactic of doctor? (Answer: to do primary surgical treatment of wound).

C. Matherials for test control. Test tasks with one right answer (α = II): 1. Early complications of traumatic injuries of maxillofacial area are:А. Secondary bleeding; В. Traumatic osteomyelytis; С. Traumatic shock; D. salivary fistulas; Е. Traumatic sinusitis. (Correct answer: С).

2. Methods of temporal hemostasis at parenchymal bleeding: А. digital occlusion of general carotid artery; В. Ligation of vessels at wound; С. Clipping on defected vessels at wound; D. compressive bandage, cold on head and neck; Е. Aseptic bandage. (Correct answer: С).

3. Patient has big edema of soft tissues and hematoma at neck and flour of oral cavity, danger of stenotic asphyxia. What kind of medical aid is necessary? А. tracheotomy; В. Using of lobeline; С. Medical symptomatical therapy; D. Fixation of tongue; Е. Primary surgical treatment of wound. (Correct answer: А).

D. Educational tasks of 3 th levels (atypical tasks): 1. Woman, 30 years, has integuments pale, on a face of a drop of sweat in two hours after road accident. Breath faltering, is complicated, pulse 120 in min., soft, the blood pressure is 70/50 mm hg, the wound of the right shchechny area getting into an oral cavity. The victim is in a prone position on a back with the thrown-back head. At survey it is revealed the fracture of the mandible in the field of the right corner and a rupture of a mucous membrane of the right cheek. What type of asphyxia develops at the victim? Make the preliminary diagnosis. What has to be tactics of the doctor?

(Answer: 1. At the patient valvate asphyxia develops. 2. Traumatic change of the right corner of the mandible. Wound of soft tissues of the right shchechny area. Valvate asphyxia. 3. To conduct subjective and objective examination of the patient, radiological inspection (the roentgenogram of the bottom jaw survey and in the right lateral projection), laboratory diagnostics, consultation of the neurosurgeon (for confirmation or close craniocerebral trauma exception), carrying out primary surgical treatment with a final hemostasia and cutting off or a podshivaniye of a rag of a mucous membrane).

2. The patient, 25 years, got a gunshot wound of the left parotid and chewing area and parotid salivary gland 4 hours ago. Consciousness of the patient is the confused. Integuments pale, breath speeded up. blood pressure is 90/60 mm hg. The wound is gapes. Massive bleeding bright red blood takes place. At the patient the left eye isn't closed, the left corner of a mouth is lowered. Than the wound gaping is caused? Why at the patient the eye isn't closed and the mouth corner is lowered? What method of a stop of bleeding should be applied? (Avswer: 1. Existence of mimic muscles. 2. Owing to injury of the left facial nerve. 3. Bandaging or vessel proshivaniye in a wound).

3. The patient has a cut wound of a lateral surface of a back of language owing to a trauma a separation disk. Integuments pale, breath is complicated owing to blood hit in respiratory ways. What type of asphyxia develops at the patient? What has to be tactics of the doctor in this case?

(Answer: 1. Aspiration asphyxia. 2. Deep deaf sewing of a wound).