dermatology
Forum Elite
Topics: 30
Posts: 293
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hey !!! i have question... kaplans says any penetrating injury in middle zone of neck (II zone) do surgical exploration no matter even if pt is stable may b due to risk of increasing size of hematoma and blocking vital tubes in neck ....
but on very next page it says can wait for 12 hours.......... penetrating wound in upper and middle zone of neck if patient is stable observe for 12 hours without expensive workup and surgery ....
its confusing can anybody please explain......
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| lakshya_0_7
Forum Elite
Topics: 22
Posts: 276
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kaplan wants to say this....
1. if gun shot or stab wound anyzone with deteriorating vitals or spittingup of blood etc-------->explore
2.gun shot zone 1 and pt stable----->do investigations-arterio/esophagogram/scopies
3.gun shot zone2 and pt stable------> explore coz its easy to do surgery in this area without any imaging ..also important structures r here
4gun shot in zone 3 and pt stable-------->do investigations-arteriography
5.stab wound in zone 1 pt stable------->do ivestigations
6.stab wound in zone 2 pt stable-------->observe..no investigations
7stab wound in zone 3 pt stable------->observe..no investigations needed...
zone 1 is lower neck {not upper}
zone 2 is middle
zone 3 is upper neck
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| dermatology
Forum Elite
Topics: 30
Posts: 293
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so acc to kaplans .... any gun shots in upper and middle neck explore after investigations and in case of stab wounds just observe no investigations required if patient is stable ....?????????????
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| lakshya_0_7
Forum Elite
Topics: 22
Posts: 276
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..........if gun shot in midle neck,,,,,,the answer is explore!!!!!!
thou it might change in the next few years,,,,,,,,,but for now,,,,,,,"EXPLOREEEEEEE"
On other things u r rite
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