PENETRATING NECK INJURIES
Some of the controversies in the management of penetrating neck injury
Zones of the neck
PPT Slide
Approach to the unstable patient
Emergency Airway Management in Penetrating Neck Injury Mandavia DP, Qualls S, Rokos I. Ann Emerg Med 2000;35:221
Hard signs of significant neck injury
Evaluation of the stable patient
Traditional algorithm
Physical examination
Continued experience with physical examination alone for evaluation & Mx of penetrating zone 2 neck injuries Sekharan J, Dennis JW et al. J. Vasc Surg 2000;32:483
What is the role of angiography in penetrating neck injury?
Is Routine Arteriography Mandatory for Penetrating Injuries to Zone I of the Neck? Eddy VA, and the Zone I Penetrating Neck Injury Study Group. J. Trauma 2000;48:208
What is the role of ultrasound in penetrating neck injury?
Evaluation of Penetrating Injuries to the Neck: Prospective study of 223 patients Demetriades D, Theodorou et al. World J Surg 1997;21:41
Does CT have a role in the evaluation of penetrating neck injury?
CT scan for surgical decision making in Zone 2 penetrating neck injuries Mazolewski PJ, Curry D et al. J. Trauma 2001;51:315
Penetrating Zone II Neck Injury: Does Dynamic CT Contribute to the Diagnostic Sensitivity of PE for Surgically Significant Injury? A Prospective Blinded Study Gonzalez RP, Falimirski M et al. J. Trauma 2003;54:61
Does the approach vary according to MOI?
Transcervical Gunshot Injuries: Mandatory operation is not necessary. Demetriades D, Theodorou D et al. J. Trauma 1996;40:78
Contemporary algorithm
Auckland Trauma Service data
Issues in Australasia
Suggested Australasian algorithm
Conclusions
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