Criteria for Emergent Airway Management in Penetrating Neck Trauma 3 Stridor The criteria for emergent airway management in penetrating neck trauma are outlined in Table 1. In traumatic neck injuries, an earlier intubation usually means an easier intubation because there is less time for airway distortion, swelling, and patient deterioration. Who Needs Immediate Airway Attention?Ī fundamental principle of airway management is that earlier airways are generally easier airways. 2 Appropriate and timely management of neck injuries is a critical skill for the emergency physician. 1 Mortality, particularly for vascular injuries, approaches 50%. Penetrating neck injuries account for up to 5%-10% of all traumatic injuries. If a neck injury is missed during the initial stages of a polytrauma evaluation, it can result in increased morbidity and mortality. The neck is the location of many vital structures. The case scenario presented here may represent one of the more challenging airways you might ever encounter. Given the extent and nature of her injury, there is concern for impending airway compromise, and it is decided to take the patient to the OR for emergent tracheotomy.įor every ED physician the trauma resuscitation starts with the ABCs: airway, breathing, and circulation. Initial assessment reveals facial swelling and large amounts of blood in the oropharynx, though she is initially stable on a non-rebreather. A 57-year-old female is brought in to the emergency department after sustaining a gunshot wound to the right face.
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