Penetrating Neck Trauma

Annotation for Point A

Initial management of patients with penetrating neck injury, which violates the platysma, should follow the advanced trauma life support guidelines, which provide the framework to identify those patients with life-threatening injuries and appropriately prioritize treatment.¹⁶ Patients who during their primary survey demonstrate ‘‘hard signs’’ (Table 2.) or hemodynamic instability^5,17 require expeditious transfer to the operating room delayed only by securing an unstable airway, with a surgical airway if attempts at oral-tracheal intubation are unsuccessful,^18-20 and attempting tamponade of active bleeding while en route. If direct pressure is unable to minimize significant active bleeding, focused attempts with balloon catheter tamponade may be of benefit.^21,22