Emergency Medicine Book

Neck Disease

  • Penetrating Neck Trauma

http://www.fpnotebook.com/

Penetrating Neck Trauma

Aka: Penetrating Neck Trauma
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  1. Symptoms
    1. Dysphagia
    2. Hoarseness
    3. Bleeding from nose or mouth
    4. Neurologic deficit
    5. Hypotension
  2. Signs
    1. Subcutaneous Emphysema
    2. Stridor
    3. Respiratory distress
    4. Expanding hematoma
    5. Active bleeding from wound site
    6. Carotid Bruit
    7. Loss of pulse
    8. Neurologic deficit (presumed ischemia)
  3. Management
    1. Zone 1: Below clavicle head
      1. Obtain Angiogram
      2. Structures at risk include common Carotid Artery, subclavian artery, Vertebral artery, trachea, esophagus
    2. Zone 2: Between clavicle head and Mandible
      1. Asymptomatic: Angiogram
      2. Symptomatic: Emergency exploratory surgery
      3. Structures at risk include Internal Carotid Artery, external Carotid Artery, Jugular Vein, trachea, Larynx, esophagus, Thyroid, recurrent laryngeal nerve
    3. Zone 3: Above Mandible angle
      1. Angiogram
      2. Structures include external Carotid Artery, Vertebral artery, Jugular Vein

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