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Penetrating neck trauma — DIPIMC MCQ

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HardPre-Hospital TraumaPenetrating neck traumaDIPIMCDipIMC

A knife wound to the lateral neck has produced an expanding haematoma, hoarseness, stridor and falling oxygen saturation. Which immediate strategy is indicated?

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Correct answer: A — Activate early expert definitive-airway care and use focal direct pressure

The best answer is “Activate early expert definitive-airway care and use focal direct pressure”. Expanding neck haematoma with voice change, stridor and hypoxaemia signals impending airway loss. Call for the most experienced airway and surgical support early, prepare a primary and rescue airway plan, maintain oxygenation and apply careful focal pressure to external bleeding. Circumferential compression, probing or deep blind packing can worsen airway obstruction, venous return or uncontrolled vascular injury.

Reference: Difficult Airway Society, 2015 unanticipated difficult tracheal intubation: https://das.uk.com/guidelines/das_intubation_guidelines