Penetrating neck trauma

Represents 5-10% of emergency department trauma cases.

89% of patients are male.

Overall mortality rate up to 11%.

Three anatomic zones anterior to the sternocleidomastoid muscles classified for penetrating trauma: Zone I extends from clavicles and sternal notch to the cricoid cartilage, Zone II extends from cricoid cartilage to angle of the mandible and Zone III from the angle to at mandible to base of the skull.

Patients with classic signs and symptoms such as acute airway obstruction, dyspnea, hemoptysis, hoarseness, subcutaneous emphysema, air bubbling through the wound, severe active bleeding, shock, rapidly increasing hematoma, absence of peripheral pulses, the presence of a carotid bruit, dysphagia, odynophagia, hematemesis and evolving stoke should have mandatory neck exploration, regardless of the zone of penetration.

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