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Blunt Neck Trauma

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1. Evaluation of the Thoracic and Lumbar Spine in Blunt Trauma

Evaluation of the Thoracic and Lumbar Spine in Blunt Trauma Evaluation of the Thoracic and Lumbar Spine in Blunt Trauma | Emergency Medicine | Washington University in St. Louis Open Menu Back Close Menu Search for: Loading... Welcome Sections Education Fellowships Research Journal Club Events Open Search Vignette You’re working a shift at a level II trauma center in the community one rainy afternoon when EMS brings in Mr. Q a 62-year old man with hypertension and hyperlipidemia who (...) imaging choices, and a quick look online directs you to a Wondering what other literature there is, you begin to conduct a more thorough search…. PICO Question Population: Adult patients suffering blunt trauma Intervention: Aspects of history (e.g. mechanism of injury) and physical exam, plain radiography Comparison: CT scan, surgical findings, follow up Outcome: Need for surgical intervention or TLSO bracing Search Strategy A systematic review and meta-analysis, recently published by a collaboration

2019 Washington University Emergency Medicine Journal Club

2. Validity and reliability of clinical prediction rules used to screen for cervical spine injury in alert low-risk patients with blunt trauma to the neck: part 2. A systematic review from the Cervical Assessment and Diagnosis Research Evaluation (CADRE) Col (PubMed)

Validity and reliability of clinical prediction rules used to screen for cervical spine injury in alert low-risk patients with blunt trauma to the neck: part 2. A systematic review from the Cervical Assessment and Diagnosis Research Evaluation (CADRE) Col To update findings of the 2000-2010 Bone and Joint Decade Task Force on Neck Pain and its Associated Disorders (Neck Pain Task Force) on the validity and reliability of clinical prediction rules used to screen for cervical spine injury (...) ranging from 99 to 100%. Inter-rater reliability of the Canadian C-spine rule varied from k = 0.60 between nurses and physicians to k = 0.93 among paramedics. The inter-rater reliability of the Nexus Low-Risk Criteria was k = 0.53 between resident physicians and faculty physicians.Our review adds new evidence to the Neck Pain Task Force and supports the use of clinical prediction rules in emergency care settings to screen for cervical spine injury in alert low-risk adult patients with blunt trauma

2017 European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

3. Blunt Trauma Neck with Complete Tracheal Transection - A Diagnostic and Therapeutic Challenge to the Trauma Team (PubMed)

Blunt Trauma Neck with Complete Tracheal Transection - A Diagnostic and Therapeutic Challenge to the Trauma Team Survival following trachea-esophageal transection is uncommon. Establishing a secure airway has the highest priority in trauma management. Airway management is a unique and a defining element to the specialty of emergency medicine. There is no doubt regarding the significance of establishing a patent airway in the critically ill patient in the emergency department. Cannot intubate (...) and cannot ventilate situation is a nightmare to all emergency physicians. The most important take-home message from this case report is that every Emergency physician should have the ability to predict "difficult airway" and recognize "failed airway" very early and be skilled in performing rescue techniques when routine oral-tracheal intubation fails. Any delay at any step in the "failed airway" management algorithm may not save the critically ill dying patient. Here, we report a case of blunt trauma

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2017 Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine

4. A Case of Pneumomediastinum Due to Blunt Neck Trauma in a 23-Year-Old Male Rugby Player (PubMed)

A Case of Pneumomediastinum Due to Blunt Neck Trauma in a 23-Year-Old Male Rugby Player BACKGROUND Pneumomediastinum is an uncommon clinical condition that usually occurs spontaneously, or is caused by blunt thoracic or abdominal trauma. This report is of a rare case of pneumomediastinum caused by blunt neck trauma in an adult and describes the clinical and radiological features and the principles of clinical management. CASE REPORT A 23-year-old man presented with increased neck swelling (...) , dysphonia and pain on swallowing (odynophagia) after blunt neck trauma during a rugby game. Chest X-ray and computed tomography (CT) showed features that were consistent with pneumomediastinum, including extensive subcutaneous emphysema. The patient was intubated and monitored in the intensive care unit (ICU) and managed with early stabilization of the airway and with conservative methods. He had no complications on clinical follow-up following hospital discharge. CONCLUSIONS Although pneumomediastinum

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2018 The American journal of case reports

5. Thyroid gland hemorrhage after blunt neck trauma: case report and review of the literature. (PubMed)

Thyroid gland hemorrhage after blunt neck trauma: case report and review of the literature. Thyroid hemorrhage is considered to be an uncommon complication following blunt trauma to the neck. This condition is potentially life-threatening due to airway compression and may therefore require emergency airway management and surgical intervention in some cases.We present the case of a 52-year-old woman who experienced a traumatic thyroid gland rupture (right lobe) with subsequent active arterial (...) bleeding from branches of the inferior thyroid artery. On the same day, the patient presented to our emergency department with a painful swelling of the neck with an inspiratory stridor and hoarseness a few hours after a cycling accident. A right hemithyroidectomy was performed. The postoperative course was uneventful. We identified 33 additional cases published in English literature within the last 30 years, reporting blunt trauma to the neck with hemorrhagic complication of the thyroid gland. We

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2017 BMC Surgery

6. Tracheal tear from blunt neck trauma in children: Diagnosis and management. (PubMed)

Tracheal tear from blunt neck trauma in children: Diagnosis and management. We describe the management of posterior trachea tears after blunt neck trauma in two children. The first, a 5 year-old boy who fell off his scooter, causing a 1.0cm tear in the membranous cervical trachea, was managed conservatively with 5 days of intubation. The second, a 12 year-old girl who fell on her bicycle, causing a 4.0cm tear in the membranous thoracic trachea, was repaired with thoracoscopic techniques

2017 International Journal of Pediatric Otorhinolaryngology

7. Delayed Stroke following Blunt Neck Trauma: A Case Illustration with Recommendations for Diagnosis and Treatment (PubMed)

Delayed Stroke following Blunt Neck Trauma: A Case Illustration with Recommendations for Diagnosis and Treatment Blunt cerebrovascular injury (BCVI) to the carotid artery is a relatively rare injury that is difficult to identify even with imaging. Any symptoms or neurological deficits following blunt neck injury mandate evaluation and consideration of BCVI. In an effort to highlight this issue, we report the case of a 31-year-old male patient who presented with left-sided weakness consistent (...) with transient ischemic attack (TIA) and concussion. The patient's symptoms occurred within 24 hours of a blunt neck injury sustained by a knee strike during a basketball game. An initial computerized tomography (CT) scan of the brain was normal; a CT angiogram (CTA) of the neck and carotids did not reveal obstruction, dissection, stenosis, or abnormalities of the carotid or vertebral vessels and the patient was subsequently discharged. A magnetic resonance imaging (MRI) of the brain obtained four days after

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2017 Case Reports in Emergency Medicine

8. Complete cricotracheal transection due to blunt neck trauma without significant symptoms (PubMed)

Complete cricotracheal transection due to blunt neck trauma without significant symptoms Laryngotracheal injuries are relatively rare but their mortality rate is fairly high. Complete disruption of trachea is extremely rare and a systematic approach is needed for early diagnosis and favourable outcome. The patients symptoms and physical signs do not necessarily correlate with the severity of the injuries and this case report highlights it. This is a case report of 25-year-old man who arrived (...) to the emergency department 8 h after a motor accident in which a rope was wrapped around his neck. Because of the good general and respiratory condition of the patient on admission, the pathognomonic signs of laryngeal injury were not noticed. A computed tomographic scan showed distortion of cricotracheal framework. Flexible bronchoscopy showed cricotracheal transaction. Immediately, the endotracheal tube was advanced distal to the transection site under bronchoscopic guide and then after neck exploration

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2017 Journal of surgical case reports

9. Surgical Management of Life-Threatening Thyroid Haematoma following Occult Blunt Neck Trauma (PubMed)

Surgical Management of Life-Threatening Thyroid Haematoma following Occult Blunt Neck Trauma A 42-year-old man arrived at the emergency department in severe respiratory distress, requiring immediate intubation and ventilation. An emergency computed tomography (CT) neck scan identified a substantial haematoma within a multinodular goitre, necessitating an emergency total thyroidectomy. It was later discovered that the patient had been the victim of an assault involving blunt trauma (...) to the anterior neck. Five days postoperatively the patient was extubated and was well enough to self-discharge the following day. Pathology revealed the lesion to be a ruptured follicular adenoma within his multinodular goitre. Signs of this rare but life-threatening condition may be subtle on initial presentation, particularly if the patient is obtunded. Patients with suspected blunt neck trauma should be observed for signs of respiratory distress. If this develops, the patient should be intubated

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2016 Case reports in endocrinology

10. Pediatric Blunt Neck Trauma Causing Esophageal and Complete Tracheal Transection. (PubMed)

Pediatric Blunt Neck Trauma Causing Esophageal and Complete Tracheal Transection. Blunt injuries to the cervical trachea remain rare but present unique and challenging clinical scenarios for prehospital providers. These injuries depend on prehospital providers either definitively securing the injured airway or bridging the patient to a treatment facility that can mobilize the necessary resources.The case presented here involves a clothesline injury to a pediatric patient that resulted (...) fiberoptic intubation or proceeding directly to tracheostomy, these techniques are not available in the prehospital environment. This case also highlights the inherent issues with proceeding to cricothyroidotomy in patients with tracheal trauma and should give all providers pause before considering this management technique.Ultimately, a systematic approach to all airways will ensure that prehospital providers are best prepared for even the most challenging scenarios.

2016 Prehospital emergency care

11. Thyroid gland rupture caused by blunt trauma to the neck (PubMed)

Thyroid gland rupture caused by blunt trauma to the neck Thyroid rupture following blunt trauma is extremely rare, and neck pain without swelling may be the only presenting symptom. However, hemorrhage and hematoma subsequently causes severe tracheal compression and respiratory distress.A 71-year-old Japanese woman visited our emergency room with a complaint of increasing right-sided neck pain at the thyroid cartilage level after she tripped and accidentally hit her neck against a pole 3 h back (...) rupture caused by blunt neck trauma have been reported in patients with normal thyroid glands and neck pain without swelling may be the only presenting symptom. When suspected, CT should be performed to confirm the diagnosis determine the optimal treatment.

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2016 BMC research notes

12. Blunt Neck Trauma

Blunt Neck Trauma Blunt Neck Trauma Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Blunt Neck Trauma Blunt Neck Trauma Aka: Blunt (...) Neck Trauma From Related Chapters II. Pathophysiology Anterior neck and throat is exposed to direct Mechanism Clothesline Injury Attempted Strangulation Sporting events or fights (e.g. punched in throat) s (e.g. steering wheel blunt injury) Potential Injuries Vascular Injury (esp. injury) See See Laryngeal Injury (e.g. ) Risk of airway compromise Injury (esp. anterior triangle injury) Risk of expanding hematoma with airway compression Higher risk if pre-existing or tumor, and in pediatric patients

2018 FP Notebook

13. Neck Vascular Injury in Blunt Force Trauma

Neck Vascular Injury in Blunt Force Trauma Neck Vascular Injury in Blunt Force Trauma Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 (...) Neck Vascular Injury in Blunt Force Trauma Neck Vascular Injury in Blunt Force Trauma Aka: Neck Vascular Injury in Blunt Force Trauma , Carotid Dissection in Blunt Neck Trauma , Carotid Artery Injury in Blunt Neck Trauma , Traumatic Carotid Dissection From Related Chapters II. Epidemiology Traumatic Carotid Dissections are rare, but potentially devastating Traumatic Carotid Dissections are most common in children Children (esp. age <6 years old) account for 73% of Traumatic Carotid Dissections

2018 FP Notebook

14. Vertebral Artery Injury in Blunt Neck Trauma

Vertebral Artery Injury in Blunt Neck Trauma Vertebral Artery Injury in Blunt Neck Trauma Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer (...) Administration 4 Vertebral Artery Injury in Blunt Neck Trauma Vertebral Artery Injury in Blunt Neck Trauma Aka: Vertebral Artery Injury in Blunt Neck Trauma From Related Chapters II. Epidemiology may be as high as 22% of blunt neck injuries (70% when C-Spine is present) III. Risk Factors IV. Mechanism l (especially C1-C3) Neck rotation or distraction Neck hyperflexion or hyperextension Facet dislocation Foramen transversarium V. Symptoms Asymptomatic initially in many cases (despite occult life threatening

2018 FP Notebook

15. Blunt Neck Trauma

Blunt Neck Trauma Blunt Neck Trauma Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Blunt Neck Trauma Blunt Neck Trauma Aka: Blunt (...) Neck Trauma From Related Chapters II. Pathophysiology Anterior neck and throat is exposed to direct Mechanism Clothesline Injury Attempted Strangulation Sporting events or fights (e.g. punched in throat) s (e.g. steering wheel blunt injury) Potential Injuries Vascular Injury (esp. injury) See See Laryngeal Injury (e.g. ) Risk of airway compromise Injury (esp. anterior triangle injury) Risk of expanding hematoma with airway compression Higher risk if pre-existing or tumor, and in pediatric patients

2018 FP Notebook

16. Neck Vascular Injury in Blunt Force Trauma

Neck Vascular Injury in Blunt Force Trauma Neck Vascular Injury in Blunt Force Trauma Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 (...) Neck Vascular Injury in Blunt Force Trauma Neck Vascular Injury in Blunt Force Trauma Aka: Neck Vascular Injury in Blunt Force Trauma , Carotid Dissection in Blunt Neck Trauma , Carotid Artery Injury in Blunt Neck Trauma , Traumatic Carotid Dissection From Related Chapters II. Epidemiology Traumatic Carotid Dissections are rare, but potentially devastating Traumatic Carotid Dissections are most common in children Children (esp. age <6 years old) account for 73% of Traumatic Carotid Dissections

2018 FP Notebook

17. Laryngeal Injury and Pneumomediastinum Due to Minor Blunt Neck Trauma: Case Report. (PubMed)

Laryngeal Injury and Pneumomediastinum Due to Minor Blunt Neck Trauma: Case Report. Serious isolated laryngeal injuries are uncommon in children.We describe the case of an 8-year-old boy with laryngeal injury and pneumomediastinum due to minor blunt neck trauma. He presented to the emergency department complaining of odynophagia and hoarseness, but without respiratory distress. Emphysema was seen between the trachea and vertebral body on initial cervical spine x-ray study, and flexible (...) laryngoscopy revealed erythema and mild edema of both the right vocal cord and the arytenoid region. He recovered with conservative management only. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: We conclude that it is important to recognize subtle evidence of laryngeal injury secondary to blunt neck trauma to ensure early diagnosis. Initial cervical spine x-ray assessment should exclude both cervical spine fracture and local emphysema after blunt neck trauma. If patients with blunt neck trauma have

2016 Journal of Emergency Medicine

18. Laryngeal laceration after blunt neck trauma in a football player (PubMed)

Laryngeal laceration after blunt neck trauma in a football player 29681963 2018 11 14 1731-5530 15 1 2018 Mar Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery Kardiochir Torakochirurgia Pol Laryngeal laceration after blunt neck trauma in a football player. 57-58 10.5114/kitp.2018.74677 Łochowski Mariusz P MP Regional Multidisciplinary Center of Oncology and Traumatology, Lodz, Poland. Rębowski Marek M Regional Multidisciplinary Center of Oncology

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2018 Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery

19. Cervical Spine Injury Risk Factors in Children With Blunt Trauma. (PubMed)

Cervical Spine Injury Risk Factors in Children With Blunt Trauma. Adult prediction rules for cervical spine injury (CSI) exist; however, pediatric rules do not. Our objectives were to determine test accuracies of retrospectively identified CSI risk factors in a prospective pediatric cohort and compare them to a de novo risk model.We conducted a 4-center, prospective observational study of children 0 to 17 years old who experienced blunt trauma and underwent emergency medical services scene (...) response, trauma evaluation, and/or cervical imaging. Emergency department providers recorded CSI risk factors. CSIs were classified by reviewing imaging, consultations, and/or telephone follow-up. We calculated bivariable relative risks, multivariable odds ratios, and test characteristics for the retrospective risk model and a de novo model.Of 4091 enrolled children, 74 (1.8%) had CSIs. Fourteen factors had bivariable associations with CSIs: diving, axial load, clotheslining, loss of consciousness

2019 Pediatrics

20. Screening for blunt cerebrovascular injuries in pediatric trauma patients. (PubMed)

Screening for blunt cerebrovascular injuries in pediatric trauma patients. Adult imaging for blunt cerebrovascular injuries (BCVI) is based on the Denver and Memphis screening criteria where CT angiogram (CTA) is performed for any one of the criteria being positive. These guidelines have been extrapolated to the pediatric population. We hypothesize that the current adult criteria applied to pediatrics lead to unnecessary CTA in pediatric trauma patients.At our center, a 9-year retrospective (...) study revealed that strict adherence to the Denver and Memphis criteria would have resulted in 332 unnecessary CTAs out of 2795 trauma patients with only 0.3% positive for BCVI. We also conducted a retrospective chart review of 776,355 pediatric trauma patients in the National Trauma Data Bank (NTDB) from 2007 to 2014. Data collection included children between ages 0 and 18, ICD-9 search for blunt cerebrovascular injury, and ICD-9 codes that applied to both Denver and Memphis criteria.Of 776,355

2019 Journal of Pediatric Surgery

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