neck trauma

Question 1

Examination findings of significant laryngeal injury

Answer 1

signs of airway obstruction
dysphonia
pneumomediastinum
hemoptysis

Question 2

Examination findings of significant vascular injury

Answer 2

active ongoing bleeding
hemorrhagic shock
pulsatile hematoma
carotid bruit/thrills

Question 3

Investigations you would arrange in a patient with a closed injury to the anterior of neck secondary to a wire injury into neck ?

Answer 3

Neck CT angiogram

nasal endoscopy

Question 4

In a patient with an isolated neck injury who need definitive airway management , what are 2 major concerns regarding securing the airway via standard RSI and direct laryngoscopy

Answer 4

1- concern of laryngeal injury and false passage of ETT

2- concern of difficult anterior access to the neck ( in case of CICO situation )

Question 5

Indication for immediate airway management in ED

Answer 5

A1-pending or complete airway obstruction
A2-unprotected airway with obtunded GCS <8
B3-marked hypoxia unresponsive to Hudson mask therapy .>85%
C4-profound shock with pending respiratory arrest

Question 6

patient with isolated neck injury (laryngeal injury ) , list the modification to RSI

Answer 6

1-Double suction setup
2-VL
3-sit patient up during induction ( if no CI )
4-double set up with a second operator standing by for front of neck access