PENETRATING NECK TRAUMA

Question 1

MANAGEMENT

Answer 1

PRIMARY SURVEY

SECONDARY SURVEY: FOCUSED EXAM OF THE HEAD AND NECK REGION

1. HEMODYNAMIC INSTABILITY?
2. HARD SIGNS OF VASCULAR INJURY?
   Shock
   Pulsatile bleeding
   Expanding hematoma
   Audible bruits
   Palpable thrill
   Nonpalpable pulse
   Signs of cerebral ischemia/stroke
3. AERODIGESTIVE INJURY?
   HARD SIGNS:
   Airway compromise
   Bubbling wound
   Extensive subcutaneous emphysema
   Stridor
   Significant hemoptysis or hematemesis

SOFT SIGNS OF VASCULAT OR AERODIGESTIVE INJURY:
Hypotension with no other etiology
Nonexpanding hematoma
Hoarseness
Dysphonia
Lateralizing neurologic deficit
Unexplained anemia