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 instability5,17 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