What are the key signs and symptoms that indicate a potential airway compromise in a patient with neck trauma?

Key signs and symptoms indicating potential airway compromise in a patient with neck trauma include:

• Stridor or noisy breathing, which suggests upper airway obstruction.
• Hoarseness or changes in voice, indicating possible laryngeal or tracheal injury.
• Difficulty or inability to speak, reflecting severe airway obstruction.
• Visible neck swelling, bruising, or expanding haematoma that may compress the airway.
• Subcutaneous emphysema in the neck or chest, indicating air leakage from airway or lung injury.
• Respiratory distress signs such as tachypnoea, use of accessory muscles, or cyanosis.
• Altered level of consciousness, which can compromise airway protective reflexes.
• Tracheal deviation or palpable fractures of the larynx or trachea.
• Bleeding from the mouth, nose, or neck wounds that may obstruct the airway.

These clinical features are critical to identify early because neck trauma can rapidly progress to complete airway obstruction. UK guidelines emphasise prompt airway assessment and management in trauma, highlighting these signs as red flags for airway compromise ¹. Recent literature on craniomaxillofacial and neck injuries further supports these indicators and stresses the importance of early recognition and securing the airway to prevent morbidity and mortality (Matos et al., 2025).