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Penetrating neck trauma — ABEM Board MCQ

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HardTraumaPenetrating neck traumaABEM Board

A 28-year-old man arrives after a knife wound to zone II of the neck. Triage acuity is ESI 1; BP 88/50 mm Hg, HR 136/min. He has expanding neck swelling, hoarseness, and active bleeding from the wound. He is anxious but still breathing spontaneously. Which of the following is the most appropriate next step in management?

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Correct answer: D — Secure the airway and take him for immediate operative exploration

Hard signs of vascular and aerodigestive injury with instability require airway control and emergent operative management rather than delayed imaging.

Reference: ATLS penetrating neck trauma guidance