Difference between revisions of "Tracheal injury"

(Background)
 
(One intermediate revision by one other user not shown)
Line 1: Line 1:
 
==Background==
 
==Background==
 +
[[File:Blausen 0865 TracheaAnatomy.png|thumb|Tracheal anatomy.]]
 
*Usually occurs at junction of trachea and cricoid cartilage
 
*Usually occurs at junction of trachea and cricoid cartilage
*direct trauma to airway is rare due to protection by sternum and mandible
+
*Direct trauma to airway is rare due to protection by sternum and mandible
 
*Associated with [[cervical spine injury]], [[head injury]], multisystem trauma
 
*Associated with [[cervical spine injury]], [[head injury]], multisystem trauma
  
 
===Common causes===
 
===Common causes===
 
*Motor vehicle accident: extended neck impacts on steering wheel or dashboard
 
*Motor vehicle accident: extended neck impacts on steering wheel or dashboard
*"clothes line injury", assaults/strangulation
+
*"Clothes line injury", assaults/strangulation
 
*Penetrating trauma (usually stabbings or gunshot wounds)
 
*Penetrating trauma (usually stabbings or gunshot wounds)
  
 
==Clinical Features==
 
==Clinical Features==
*[[Respiratory distress[[
+
*[[Respiratory distress]]
 
*Hoarseness, [[dysphonia]], [[cough]], [[stridor]], [[dysphagia]]
 
*Hoarseness, [[dysphonia]], [[cough]], [[stridor]], [[dysphagia]]
 
*Subcutaneous emphysema
 
*Subcutaneous emphysema

Latest revision as of 13:48, 10 April 2021

Background

Tracheal anatomy.
  • Usually occurs at junction of trachea and cricoid cartilage
  • Direct trauma to airway is rare due to protection by sternum and mandible
  • Associated with cervical spine injury, head injury, multisystem trauma

Common causes

  • Motor vehicle accident: extended neck impacts on steering wheel or dashboard
  • "Clothes line injury", assaults/strangulation
  • Penetrating trauma (usually stabbings or gunshot wounds)

Clinical Features

Differential Diagnosis

Thoracic Trauma

Evaluation

Investigate only once airway secure

Management

While preparing to secure airway

AIRWAY MANAGEMENT

Avoid cricoid pressure!

  • Awake fiberoptic intubation
  • Awake direct laryngoscopy/intubation
  • Inhalational induction/intubation (keep patient breathing spontaneously)
  • Awake tracheostomy
  • Consider intubating through open wound if transected trachea visible

Disposition

  • Admit

See Also

External Links

References