How Do I Treat a Neck Injury?

Neck injuries are injuries to the neck structure caused by mechanical external forces and chronic strain. They are less common than injuries to the limbs and abdomen, and can be divided into two types: open injury and closed injury. Closed injuries are more common in boxing and strangulation injuries. In addition to causing hematomas and subcutaneous emphysema, they often have unconsciousness, pulse pulsation, and blood pressure drop. At the same time, hematomas can compress the trachea and cause asphyxia, or the carotid artery is stimulated, which can cause Reflex blood circulation disorder in the brain. Open injuries are rare and can be seen in traffic accidents, accidents, and production accidents; in wartime, they are more common in knife and bullet injuries.

Basic Information

Visiting department: General Surgery
Common causes: Caused by mechanical external forces and chronic strain.

Common symptoms: Major bleeding, dyspnea, shortness of breath, rapid heart rate, etc.
Contagious: no

Causes of neck injuries

Closed injuries are more common in boxing and strangulation injuries; open injuries are usually seen in traffic accidents, accidents, production accidents, cuts, stab wounds, etc .; wartime injuries are more common in knife and bullet injuries.

Clinical manifestations of neck injury

1. Cervical artery injury The most severe manifestations of this disease are major bleeding and shock, followed by airway obstruction due to neck swelling and hematoma formation. Neurological symptoms include ipsilateral sympathetic nerve paralysis leading to Horner syndrome, symptoms are as follows: The pupil on the ipsilateral side is narrowed, the upper eyelid is drooping and the eyes are narrow, the eyeball is sunken, and the affected side has no sweat. Arteriovenous fistula can be formed if the large vein is damaged at the same time.
2. Jugular vein injury Jugular vein injury can cause severe bleeding, but the main danger is the occurrence of air embolism, especially the veins at the root of the neck. The wall adheres to the neck fascia, and the venous cavity is not easy to collapse after injury, allowing air to enter the vein. Coupled with the patient's fear and shortness of breath, a large amount of air enters the heart, which stops the heart beat and the patient dies.
3. Thoracic duct injury Patients with thoracic duct injury suddenly have shortness of breath, dyspnea, or even cyanosis, increased heart rate, weakened pulse, decreased blood pressure, and other shock-like symptoms, followed by a large amount of pleural effusion. The puncture and drainage were initially bloody fluid. Then it turned into a typical milky white chyme; after the puncture and aspiration, the patient's shortness of breath and dyspnea eased, but the symptoms relapsed shortly, and the chest puncture and aspiration were repeated. Patients consume quickly, with progressive dehydration, electrolyte disturbances, and malnutrition; they eventually die from systemic failure, and can also die from severe infection or sepsis due to low resistance.
4. Laryngeal and tracheal injuries Laryngeal and tracheal injuries are mainly manifested by dyspnea, air and foam-like blood spurts from the wound, and may be accompanied by a severe irritating cough. If blood enters the trachea, aspiration suffocation may occur.
5. Throat and esophageal injuries are often accompanied by larynx, trachea, and blood vessel injuries. In addition to swallowing pain, saliva, blood, food, and air often overflow from the breach.
6. Nerve nerve injury (1) Recurrent laryngeal nerve injury: Unilateral recurrent laryngeal nerve injury is paralysis of one side of the abductor and adductor muscles, hoarseness and weakness of speech; bilateral recurrent laryngeal nerve injury may have difficulty breathing. .
(2) Brachial plexus injury: mainly causes paralysis of the shoulder and upper arm muscles, manifested as sagging of the upper arm, no abduction and external rotation, no flexion and outward rotation of the forearm, no extension of the wrist and metacarpophalangeal joints, numbness of the upper limbs, feeling Lost.
(3) Vagus nerve injury: Ipsilateral vocal cord paralysis, hoarseness, paroxysmal tachycardia, and arrhythmia occur on one side of the vagus nerve injury.
(4) accessory nerve injury: after the accessory nerve is injured, the head is slightly deviated to the healthy side, the affected side is drooping, and the position of the scapula is skewed.

Neck injury examination

Usually diagnosed by CT, direct laryngoscope, fiberoptic bronchoscope, venipuncture, and cardiac puncture can assist diagnosis.

Diagnosis of neck injury

Based on the patient's neck trauma history and clinical manifestations, a preliminary diagnosis can be made, and necessary auxiliary examinations can be made according to the condition to clear the diagnosis or guide the treatment.

Neck injury treatment

The principle of first aid treatment is to keep the airway open, followed by controlling major bleeding, and then to perform different treatments according to the cause of injury, injury and other conditions.