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

Neck zones 1

Management algorithm

penatrating neck 1

In CUH, neck wounds requiring exploration should be admitted under the care of the general surgical consultant on call. The surgical team may refer on to vascular / radiology / ENT / plastics as required.



Content by Dr Íomhar O' Sullivan 20/06/03.   Reviewed by Dr ÍOS 13/07/2004, 08/07/2005, 22/03/2007.Last review Dr ÍOS 21/06/21.