Approach to penetrating neck injury Quiz: Ace Your Exams
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A 77-year-old woman presents to the trauma bay after a motor vehicle collision. The patient veered off the road to avoid an animal and hit a tree. Airbags deployed, and part of a branch went through the windshield, impaling the patient in the neck. Upon arrival to the emergency department, the primary survey is intact. Temperature is 36 °C (98 °F), heart rate is 124, blood pressure is 136/72, and respiratory rate 14. Secondary survey reveals a branch (diameter 1.5 cm) entering and exiting the left neck in Zone 2, as well as left knee tenderness. All distal pulses are palpable. CT-A of the head, neck and chest shows a blush indicating potential injury near the left carotid artery but is otherwise negative. Given the concern for laryngotracheal and pharyngoesophageal injuries, a triple endoscopy is performed and is negative. The patient remains hemodynamically stable. Which of the following is the most appropriate next step in management?
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