Penetrating Neck Trauma
Initial management
Airway
- Surgical emphysema or air bubbling may indicate a breach in larynx/ trachea
- Stridor due to haematoma both may require surgical airway
- (c-spine precautions not necessary unless mechanism suggests fracture or cord injury. Also, neck swelling with a collar may cause jugular venous hypertension) Ref 1
Breathing
- Pneumothorax especially with lower zone injuries
Circulation
- External haemorrhage or expanding haematoma, venous air embolus, dissection (bruit/ Horner's)
Disability
- Evolving CVA, spinal cord injury, brachial plexus injury
Exposure
- Oesophageal injury- local infection or mediastinitis
Anatomical zones
Management flow diagram
Links & References
Ref 1 Arishita GI, Vayer JS, Bellamy RF: Cervical spine immobilization of penetrating neck wounds in a hostile environment, J Trauma 29(3):332, 1989
