Anesthetic Management of Neck Trauma

Guidelines for Emergency Tracheal Intubation Immediately after Traumatic Injury

“…14,16,22,23,31,32,38,41,50,57,65,74,81,109,111,113,115,116,119,144,145 (For tables, see EAST Web site: www.east.org/trauma practice guidelines/Emergency Tracheal Intubation Following Traumatic Injury.) The majority of the 6,486 patients in these studies underwent emergency tracheal intubation.…”

“…52,57,58,64,68,109 -120 Specifically, patients with laryngotracheal injury frequently have airway obstruction or respiratory distress, and the majority require emergency tracheal intubation. 52,57,58,111,[113][114][115][116][117][118][119][120] The literature also indicates that patients with severe maxillofacial injury can have airway obstruction and frequently need emergency tracheal intubation. [121][122][123][124][125][126][127][128] Other patients with severe cognitive impairment commonly have airway obstruction (26 -45%) and associated hypoxemia (15-55%).…”

Blind Nasotracheal Intubation for Patients With Penetrating Neck Trauma

“…4 Two studies investigating airway management in cases of penetrating neck trauma included the use of BNTI, but the results were inconclusive because of the small number of cases and the lack of details regarding success rates and outcomes. 5,8 In the current study, 45% of the patients requiring airway management in the field underwent BNTI. There was no documentation showing that BNTI caused further airway damage in these patients.…”

Elusive penetrating foreign body to the neck causing partial epiglottic airway obstruction

“…ATLS Ò focuses on the key areas of airway, breathing and circulation. The stable patient may have impending airway compromise due to loss of structural integrity, distortion or obstruction by surgical emphysema, fluids or a foreign body (Ginsberg and Freinkel, 1969;Herrin et al, 1979;Eggen and Jorden, 1993;Shearer and Giesecke, 1993;Mandavia et al, 2000;Weitzel et al, 2004;Powitzky et al, 2008). The neck is also at high risk from haemorrhage from the great vessels.…”