Please use the practice that is standard at your trauma center. As a recap: Trauma to the neck is bad. Youssef N, Raymer KE. 5. J Thorac Cardiovasc Surg. The neck has been decided into threes zones. I know what zone the neck injury is inâ¦now what? Of note, there is a concept of âNo Zoneâ. This aides in trauma injury evaluation. Zone III, above the angle of the mandible, is treated as a head injury. 62. Injuries to this zone that penetrate the platysma generally warrant exploration, and prompt surgery is required in unstable patients. 1978;76:633-638. Vascular injury is the most common complication of penetrating neck trauma, occurring in 25%, with mortality of nearly 50%. Scan Can Be Used for Surgical Decision Making in Zone 2 Penetrating Neck Injuries.The Journal of Trauma. Atteberry LR, Dennis JW, Menawat SS, et al. Management of penetrating trauma to the neck. McConnell DB, Trunkey DD. The neck trauma zones are illustrated. Role of angiography in cervicothoracic trauma. 63. Thomas AN, Goodman PC, Roon AJ. Zone II, between Zones I and III, is the area of controversy. Asensio, JA Valenziano CP, Falcone RE, Grosh JD. This shows a lateral view of the 3 anatomic zones of the neck. Trauma. Apffelstaedt JP, Müller R. Results of mandatory exploration for penetrating neck trauma. 4. Adv Surg 1994; 27:97. example, injuries in Zone 3 are markedly different than those in Zone 1. 2 . PubMed PMID: 24192521. Emerg Med Clin North Am. J Am Coll Surg. STN E-Library 2012 14 8_Neck Trauma. J Trauma.1991;31:1614-1617. Figure 13.1 Zones of the neck as defined for purposes of trauma Zone II extends from the angle of the mandible superiorly to the cricoid cartilage inferiorly. Anatomically, the neck is sectioned out by regions, or zones. Walls RM. O'Donnell VA, Atik M, Pick RA. From the case: Neck trauma injury zones (diagram) Diagram. Zone 2 injuries are the most common, followed by Zone 1, and then Zone 3 1. World J Surg1994; 18:917. What matters is how your patient is doing. Evaluation and management of penetrating wounds of the neck: the role of Airway management of an open penetrating neck injury. Stable penetrating neck trauma patients, regardless of zone, should first undergo CTA. Serious injuries may not be clinically obvious making diagnosis and prompt treatment challenging. Background: Patients with penetrating neck trauma can present with a variety of injury patterns including hemorrhagic shock, airway obstruction and neurologic injury. Physical examination alone is safe and accurate for evaluation of vascular injuries in penetrating zone II neck trauma. 1998 Feb;16(1):45-61 PMID: 9496314. 2013;15(0):1-5. 1994;179:657â662. There are 3 zones (see previous neck trauma post). Due to the large number of critical structures in the neck, a clear knowledge of the anatomy is ⦠Zone I, including the thoracic inlet, up to the level of the cricothyroid membrane, is treated as an upper thoracic injury. Management of the difficult airway in the trauma patient. Management of penetrating neck injuries. CJEM. FOAM and web resources. In fact, the zones donât really matter. It is important to note that some trauma centers have moved away from using the âzonesâ in penetrating neck trauma, and have instead used a zone free or âno-zoneâ approach with using CTA of the neck as first line diagnostic imaging. 3. Penetrating zone-II neck injuries in children. 2001; 51: 315-319 ⢠14 stable patients with zone II injuries ⢠PE, CT scan & operative exploration performed ⢠CT scan = high /low probability for injury ⢠Surgical findings compared with preoperative CT Penetrating Neck Trauma 2,3,6 107. STN E-Library 2012 15 8_Neck Trauma ⢠Zone 1 extends from the base of the neck â¦
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