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Penetrating Neck Trauma

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Penetrating Neck Trauma PowerPoint Presentation

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Published on : Jan 08, 2015
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Slide 1 - Penetrating Neck Trauma: Simulation Case Debriefing Cullen B. Hegarty, M.D. Regions Hospital Department of Emergency Medicine
Slide 2 - Debriefing: How did the case feel? What went well? What would you change/do differently? Crisis Resource Management review Review of objectives and optimal management of the case
Slide 3 - Case checklist: Address IV access, fluids Order appropriate labs/blood products Complete primary and secondary survey with full exposure/skin exam and vascular exam noted Pain management Early airway management with rescue technique(s) if needed Coordinate final disposition for patient
Slide 4 - Penetrating Neck Trauma: Penetrating Neck Injury Karim Brohi, trauma.org 7:6, June 2002
Slide 5 - Injuries: Stab wounds to the neck can result in: -Vascular -Neurologic -Laryngotracheal and/or -GI injuries
Slide 6 - ED Management: Basic stabilization techniques -ATLS Primary/Secondary surveys -emphasis on exposure for other injuries -screening x-rays (ex: CXR) -early airway management Diagnostic workup of injury
Slide 7 - Diagnostic work-up Zone III: angiography if stable Zone I: CXR, angiography, GI study (esophagoscopy vs contrast study) if stable Zone II: OR for exploration versus (if stable) -studies of potential injuries: angiogram, bronchoscopy, and GI study -CT soft tissue neck -clinical observation for signs/symptoms All ‘Zones’ if unstable may need OR
Slide 8 - Summary: Review of case, performance of clinical management and team Review of penetrating neck injury -Zones of neck -Basic trauma stabilization techniques -Management of injuries based on location of wound/zone
Slide 9 - References: Penetrating Neck Injury Karim Brohi, trauma.org 7:6, June 2002 http://www.trauma.org/vascular/neckneur.html Hamilton et al: Chapter 48 ‘Head and Neck Trauma’, pp 843-869. ‘Emergency Medicine- An Approach to Clinical Problem-Solving, 2nd Edition’,Philladelphia, W.B. Saunders Company, 2003.