What should be avoided in patients with suspected facial or basilar skull fractures?

In patients with suspected facial or basilar skull fractures, the use of intranasal instruments should be avoided because these can potentially lead to further complications. Intranasal instruments might inadvertently penetrate or disrupt the underlying anatomy, including the cranial cavity or the nearby structures that could be compromised by the fracture. There is also a risk of creating a direct pathway for bacteria to enter the central nervous system, possibly leading to meningitis or other serious infections.

With facial fractures, there's a possibility of a cerebrospinal fluid (CSF) leak, especially in basilar skull fractures. Inserting instruments intranasally in such cases could aggravate this condition or increase the risk of contaminants entering the CSF space. Therefore, it's crucial to avoid any procedure that could exacerbate risktaking advantage of the structural vulnerability presented by these types of fractures.

Other procedures like eye exams, abscess drainage, and peripheral IV access might still be conducted with proper caution or consideration of the clinical situation. Specifically, eye exams are generally safe unless there is significant ocular involvement; abscess drainage can be performed with consideration of the risk of vascular compromise; and peripheral IV access is a standard procedure in many settings, even with facial fractures. The primary concern with facial or bas