Week 6: Laryngeal Trauma (upper airway disorder)

Question 1

Is this rare?

Answer 1

yes, due to the protected location of the larynx, with the hard, bony structure of the cervical spine posterior and the mandible in a superior and anterior position

Question 2

Mostly Seen?

Answer 2

in females because of their slimmer, longer necks but,

-males present with the highest percentage because of a greater participation in body-contact sports (fighting0

Question 3

How does Laryngeal trauma occur?

Answer 3

-as a result of blunt or penetrating injuries, inhalation of caustic agents to the neck, or pressure from prolonged endotracheal intubation

Question 4

Blunt trauma

Answer 4

can occur as a result of assaults, crash injuries, falls, motor vehicle crashes, sports, or strangulation

Question 5

Penetrating Injuries

Answer 5

occur from gunshots or stabbings

Question 6

Clinical Manifestations

Answer 6

dependent on the extent of the injury
-hoarseness, stridor, dyspnea (difficulty breathing), dysphagia (difficulty swallowing), and hemoptysis (bloody sputum)
>the airway can become obstructed from edema or fracture of the laryngeal structures or hematoma development

Question 7

Diagnosis

Answer 7

completed by a physical examination of the neck for signs of swelling, discoloration, subcutaneous emphysema, tracheal deviation, and open wounds

Question 8

Diagnostic Procedures

Answer 8

• physical examination of the neck
• cervical CT
• fiberoptic laryngoscopy
• flexible bronchoscopy

Question 9

Laryngoscopy and Flexible Bronchoscopy

Answer 9

the provider uses a flexible tube with a fiberoptic system to view structures in the upper and lower airways

Question 10

Priority of care for a person with Laryngeal Trauma?

Answer 10

ensure and maintain a patent airway

Question 11

Maintenance of Airway may include:

Answer 11

-endotracheal intubation or tracheostomy

Question 12

What might also be indicated for maintenance besides airway patency?

Answer 12

-stabilization of cervical spine is vital due to the potential of cervical spine injury

Question 13

Surgical Interventions

Answer 13

• evacuation of hematoma
• repair of lacerations
• stabilization/ repair of fractures

Question 14

Symptoms of Laryngeal trauma are due to?

Answer 14

injury to the vocal cords and edema pf the soft tissue of the neck

Question 15

Nursing Care: Assessment

Answer 15

• assess vital signs (increase in respiratory and HR, decreased oxygen saturation, and tachypnea indicate respiratory distress
• physical assessment of the neck and upper airway (identify risk for trauma if discoloration, change in voice, stridor, use of accessory muscles for breathing, or restlessness indicating hypoxia are present)

Question 16

Nursing Care: Actions

Answer 16

• have tracheostomy insertion tray and emergency equipment at the bedside
• provide humidified air via face mask or face tent (cool humidified air will help decrease airway edema)
• keep head of the bed elevated at 45 degrees (assist in decreasing edema and maintain patent airway)
• aspiration precautions (NPO status)

Question 17

Client Education

Answer 17

• symptoms to report and when to seek emergency medical care (a compromise in airway patency can quickly progress to airway occlusion and death)
• maintenance of voice rest