Video - Neck trauma: Clinical

Neck trauma refers to any type of injury to the neck, which is the area of the body between the head and the shoulders. It is classified into blunt neck trauma (e.g. injuries caused by motor vehicle accidents), and penetrating trauma (e.g. neck stab injuries). It is a penetrating neck injury if the platysma muscle is torn.

The management of blunt neck trauma follows ABCDEs (airway, breathing, circulation, disability, and exposure) sequence. Intubation should be done quickly to clear the airway (if not clear, and the cervical spine immobilized with a cervical collar. Next, reference to clinical decision tools such as the NEXUS or Canadian C-spine rule is necessary to determine if the C-spine is “cleared”, or if CT imaging is necessary to decide surgical vs non-surgical definitive management.

ABCDEs sequence also applies to penetrating neck injury. Securing the airway may require orotracheal intubation, or emergent cricothyrotomy if necessary. Hemorrhage control is done by direct pressure on the wound, and if that doesn't suffice, a Foley catheter is inflated in the wound to occlude it. For hemodynamically unstable individuals, emergency surgery is required. With penetrating neck injuries cervical collars are usually not necessary unless they are associated with a neurological deficit or a suspected concomitant blunt neck injury.