Case Report

GUNSHOT WOUND TO THE NECK: NOT AN EASY AIRWAY

Volume: 10 Number: 1 January 1, 2019
  • Chady El Tawil *
  • Nadine El Hajj
  • Nagham Faris
EN

GUNSHOT WOUND TO THE NECK: NOT AN EASY AIRWAY

Abstract

Introduction: Securing the airway is the first and most important part in any trauma as per the Advanced Trauma Life Support (ATLS) guidelines, and an injury to the face and/or neck can lead to devastating results if the airway was not secured.

Objective: A penetrating neck injury can be a life-threatening event if the airways were not secured.

Case Report: 26 years old female patient was transferred to our Emergency Department (ED) from a rural secondary care facility, for a self inflicted, close range, GSW to the thyroid cartilage by a low velocity firearm. An attempt of oropharyngeal intubation was unsuccessful and as the patient’s saturation was dropping, the surgeon present in the rural ED elected to expand the entry wound and insert the tube directly through the trachea and transfer the patient to our tertiary care center.

Conclusion: Securing the airways remains the most critical and challenging part even for the most skilled emergency physicians. At least a second and third alternatives should be prepared and ready in case of failure of intubation.

Keywords

References

  1. 1. ATLS Subcommittee; American College of Surgeons’ Committee on Trauma and International ATLS working group. Advanced trauma life support (ATLS®): the ninth edition. J Trauma Acute Care Surg 2013; 74: 1363–6.
  2. 2. Hiraoka C, Ikuta Y, Yamamoto T. A Case of Penetrating Injury of the Neck in Which It Was Difficult to Secure the Airway. Masui 2015; 64: 1052-5.
  3. 3. Liew G, Leong XF, Wong T. Awake tracheal intubation in a patient with a supraglottic mass with the Bonfils fibrescope after failed attempts with a flexible fibrescope. Singapore Med J. 2015; 56: e139–41.
  4. 4. Saricicek V, Sahin L, Mizrak A, Sen E. Endotracheal intubation of a paediatric patient with an umbrella wire embedded in the palate to the posterior wall of the nasopharynx using a GlideScope video laryngoscope. Case Reports 2014; 2014: bcr2014204478.
  5. 5. Weitzel N, Kendall J, Pons P. Blind nasotracheal intubation for patients with penetrating neck trauma. J Trauma. 2004; 56: 1097-101.
  6. 6. Lehavi A, Weisman A, Katz Y. Retrograde tracheal intubation--an alternative in difficult airway management. Harefuah. 2008; 147: 59-64, 93.
  7. 7. Bhattacharya P, Mandal MC, Das S, Mukhopadhyay S, Basu SR. Airway Management of Two Patients with Penetrating Neck Trauma. Indian J Anaesth. 2009; 53: 348-51.

Details

Primary Language

English

Subjects

-

Journal Section

Case Report

Authors

Chady El Tawil * This is me

Nadine El Hajj This is me

Nagham Faris This is me

Publication Date

January 1, 2019

Submission Date

March 8, 2018

Acceptance Date

-

Published in Issue

Year 2019 Volume: 10 Number: 1

APA
El Tawil, C., El Hajj, N., & Faris, N. (2019). GUNSHOT WOUND TO THE NECK: NOT AN EASY AIRWAY. Journal of Emergency Medicine Case Reports, 10(1), 5-6. https://doi.org/10.33706/jemcr.550591
AMA
1.El Tawil C, El Hajj N, Faris N. GUNSHOT WOUND TO THE NECK: NOT AN EASY AIRWAY. Journal of Emergency Medicine Case Reports. 2019;10(1):5-6. doi:10.33706/jemcr.550591
Chicago
El Tawil, Chady, Nadine El Hajj, and Nagham Faris. 2019. “GUNSHOT WOUND TO THE NECK: NOT AN EASY AIRWAY”. Journal of Emergency Medicine Case Reports 10 (1): 5-6. https://doi.org/10.33706/jemcr.550591.
EndNote
El Tawil C, El Hajj N, Faris N (January 1, 2019) GUNSHOT WOUND TO THE NECK: NOT AN EASY AIRWAY. Journal of Emergency Medicine Case Reports 10 1 5–6.
IEEE
[1]C. El Tawil, N. El Hajj, and N. Faris, “GUNSHOT WOUND TO THE NECK: NOT AN EASY AIRWAY”, Journal of Emergency Medicine Case Reports, vol. 10, no. 1, pp. 5–6, Jan. 2019, doi: 10.33706/jemcr.550591.
ISNAD
El Tawil, Chady - El Hajj, Nadine - Faris, Nagham. “GUNSHOT WOUND TO THE NECK: NOT AN EASY AIRWAY”. Journal of Emergency Medicine Case Reports 10/1 (January 1, 2019): 5-6. https://doi.org/10.33706/jemcr.550591.
JAMA
1.El Tawil C, El Hajj N, Faris N. GUNSHOT WOUND TO THE NECK: NOT AN EASY AIRWAY. Journal of Emergency Medicine Case Reports. 2019;10:5–6.
MLA
El Tawil, Chady, et al. “GUNSHOT WOUND TO THE NECK: NOT AN EASY AIRWAY”. Journal of Emergency Medicine Case Reports, vol. 10, no. 1, Jan. 2019, pp. 5-6, doi:10.33706/jemcr.550591.
Vancouver
1.Chady El Tawil, Nadine El Hajj, Nagham Faris. GUNSHOT WOUND TO THE NECK: NOT AN EASY AIRWAY. Journal of Emergency Medicine Case Reports. 2019 Jan. 1;10(1):5-6. doi:10.33706/jemcr.550591