Emergency airway management in penetrating neck injury

Mandavia, Diku; Qualls, Stephanie; Rokos, Ivan C.

doi:10.1016/s0196-0644(00)70071-0

Cited by 84 publications

(60 citation statements)

References 11 publications

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“…1). A detailed history revealed psychiatric illness to be the cause of this self inflicted injury [2]. His vitals were found to be stable, he had no respiratory embarrassment and was conversing comfortably, though with a minimal change of voice.…”

Section: Case Reportmentioning

confidence: 90%

A unique method of intubating an unusual neck injury with knife-in-situ

Ahlawat

Jaiswal

Singhal

et al. 2015

Egyptian Journal of Anaesthesia

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A young male, aged 32 years, was brought to the emergency operation theatre, with a household knife-in-situ, in the neck. A detailed history revealed psychiatric illness to be the cause of this self inflicted injury. His vitals were found to be stable and he had no respiratory embarrassment and was conversing comfortably. Intubating him with a knife-in-situ was a great challenge. A simple technique using two endotracheal tubes was used which helped in securing the airway avoiding any further injury with the knife-in-situ.

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Section: Case Reportmentioning

confidence: 90%

A unique method of intubating an unusual neck injury with knife-in-situ

Ahlawat

Jaiswal

Singhal

et al. 2015

Egyptian Journal of Anaesthesia

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“…[18][19][20][21][22][23] Rapid sequence intubation (RSI) can be considered in cases where the airway is felt to be threatened but normal anatomy and structure relationship are well preserved. 18,24,25 In a retrospective study of more than 700 patients with PNI, Mandavia and colleagues found RSI to be safe and effective, with all of the 39 patients successfully intubated in this manner, compared to awake fibre-optic intubation, which was successful in 9 of 12 patients (three failures being rescued with RSI). 24 Although the results of this study would seem to support the safety of RSI in PNI, they may not apply to the 10% of patients with PNI who have a primary airway injury, 5 a subset that may not be identified on initial presentation.…”

Section: Discussionmentioning

confidence: 99%

“…18,24,25 In a retrospective study of more than 700 patients with PNI, Mandavia and colleagues found RSI to be safe and effective, with all of the 39 patients successfully intubated in this manner, compared to awake fibre-optic intubation, which was successful in 9 of 12 patients (three failures being rescued with RSI). 24 Although the results of this study would seem to support the safety of RSI in PNI, they may not apply to the 10% of patients with PNI who have a primary airway injury, 5 a subset that may not be identified on initial presentation. A much smaller review performed at a Canadian tertiary trauma centre revealed variability in airway management in PNI.…”

Section: Discussionmentioning

confidence: 99%

Airway management of an open penetrating neck injury

Youssef

Raymer

2015

CJEM

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Although penetrating neck injuries (PNIs) represent a small subset of patients presenting to the emergency department (ED), they can result in significant morbidity and mortality. The approach to airway management in PNI varies widely according to clinical presentation and local practice, such that global management statements are lacking. Although rapid sequence intubation (RSI) may be safe in most patients with PNI, the high-risk subset (10%) of patients with laryngotracheal injury require particularly judicious airway management. It is not known if RSI is safe in such patients, nor has there been reported use of videolaryngoscopy in patients with open PNI. Established principles of airway management in patients with an open airway injury include the avoidance of both positive pressure bag-mask ventilation and blind tube passage and the early consideration of a surgical airway. Because this high-risk subset may not be clinically apparent on initial presentation in the ED, such guiding principles apply to all patients with PNI until the nature of the injury is more accurately defined. In this report, we present the case of a patient who presented to the ED with a zone II open PNI, which occurred as a result of a stab wound. RÉ SUMÉBien que les plaies pé né trantes du cou (PPC) repré sentent un faible pourcentage des cas traité s dans les services d'urgence (SU), elles peuvent né anmoins entraîner une forte morbidité et une forte mortalité . Les interventions en vue du maintien de la permé abilité des voies aé riennes dans les cas de PPC varient é normé ment selon le tableau clinique et les pratiques locales, au point que les dé clarations sur la prise en charge gé né rale manquent. Si l'intubation en sé quence rapide (ISR) est sans danger chez la plupart des patients souffrant d'une PPC, le maintien de la permé abilité des voies aé riennes dans le sous-groupe de patients à risque é levé (10%) pré sentant des lé sions laryngotraché ales exige des interventions particuliè rement judicieuses. On ne sait pas si l'ISR est sû re chez ces patients, et la documentation ne fait pas é tat non plus de l'utilisation de la vidé olaryngoscopie chez les patients souffrant d'une PPC bé ante. Les principes dé jà é tablis du maintien de la permé abilité des voies aé riennes dans les cas de blessure bé ante des voies aé riennes comprennent le non-recours à la ventilation par masque et ballon à pression positive et à l'intubation à l'aveugle ainsi que la possibilité d'une ouverture chirurgicale pré coce des voies aé riennes. Comme les lé sions dans ce sous-groupe de patients à risque é levé peuvent ê tre non dé celables cliniquement à la premiè re consultation au SU, ces principes de conduite s'appliquent à tous les blessé s pré sentant une PPC jusqu'à ce que la nature du trauma soit davantage pré cisé e. Sera exposé ici le cas d'une patiente traité e au SU pour une PPC bé ante de la zone II, par suite d'une agression à l'arme blanche.

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“…Tension pneumothorax should be treated immediately when signs are recognized. Orotracheal rapid sequence intubation is the most common method of emergent airway management and is utilized in approximately 80% of patients with penetrating injuries with a high success rate [29]. However, in 12% the orotracheal intubation may fail and an alternative procedure will be required [30].…”

Section: Management Of Penetrating Neck Injuriesmentioning

confidence: 99%

Role of Selective Management of Penetrating Injuries in Mass Casualty Incidents

Talving

DuBose²,

Barmparas³

et al. 2009

Eur J Trauma Emerg Surg

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Terrorist violence has emerged as an increasingly common cause of mass casualty incidents (MCI) due to the sequelae of explosive devices and shooting massacres. A proper emergency medical system disaster plan for dealing with an MCI is of paramount importance to salvage lives. Because the number of casualties following a MCI is likely to exceed the medical resources of the receiving health care facilities, patients must be appropriately sorted to establish treatment priorities. By necessity, clinical signs are likely to prove cornerstones of triage during MCI. An appropriate and effective application of experiences learned from the use of selective nonoperative management (SNOM) techniques may prove essential in this triage process. The present appraisal of the available literature strongly supports that the appropriate utilization of these clinical indicators to identify patients appropriate for SNOM is essential, critical, and readily applicable. We also review the initial emergent triage priorities for penetrating injuries to the head, neck, torso, and extremities in a mass casualty setting.

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Emergency airway management in penetrating neck injury

Cited by 84 publications

References 11 publications

A unique method of intubating an unusual neck injury with knife-in-situ

A unique method of intubating an unusual neck injury with knife-in-situ

Airway management of an open penetrating neck injury

Role of Selective Management of Penetrating Injuries in Mass Casualty Incidents

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