DrVirgo
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Neck Trauma:
What is the management of:
-gun shot wounds to:
---Zone 1
---Zone 2
---Zone 3
-stab wounds to:
---Zone 1
---Zone 2
---Zone 3
Which Zone of the neck contains the most vital structures?
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| DrVirgo
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Ok, maybe you all can help me fill in the blanks.
(zone 1= lower, zone 2= middle, and zone 3 is upper neck)
If penetrating neck wound + Unstable = Immediate surgical exploration.
-gun shot wounds to:
---Zone 1 -Arteriography, Esophagogram (water soluble, followed by barium if negative) Esophagoscopy, and bronchoscopy before surgery.
---Zone 2 -ALWAYS go to OR! (even if he is stable)
---Zone 3 -Arteriographic dx
-stab wounds to:
---Zone 1 - ???
---Zone 2 -If asymptomatic, observe. If symp =?
---Zone 3 -If asymptomatic, observe. If symp =?
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| Doc750
transfer:step 3 prison
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Posts: 636
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uses angiography (and esophagoscopy / endoscopy) with injuries involving Zones I and III. With Zone I, a preoperative Vascular Surgery consult may be in order; in Zone III, a Neurosurgery consult may prove beneficial.
In Zone II, Mandatory Operative Exploration can be recommended without reserve; preoperative angiographic studies are then dependent on the anatomical location of the penetrating wound
http://www.ispub.com/ostia/index.php?xmlFilePath=...
My kaplan notes are still in storage. I'll try and dig them up this weekend, and find the chart out of there.
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| DrVirgo
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Topics: 1082
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Thanks... I was looking for clear cut answers, but I guess it's not that simple when it comes to neck wounds... There always seems to be a lot of rules and then exceptions to the rule. If you find the chart, please post it; I would really appreciate it.
Nice avatar -I thought I was seeing double. 
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| Sayulita
Forum Guru
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Posts: 538
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nothing is simple
good question/ post
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