Ver el código de «Tracheal injury»

==Background==
[[File:Blausen 0865 TracheaAnatomy.png|thumb|Tracheal anatomy.]]
*Usually occurs at junction of trachea and cricoid cartilage
*Direct trauma to airway is rare due to protection by sternum and mandible
*Associated with [[cervical spine injury]], [[head injury]], multisystem trauma

===Common causes===
*Motor vehicle accident: extended neck impacts on steering wheel or dashboard
*"Clothes line injury", assaults/strangulation
*Penetrating trauma (usually stabbings or gunshot wounds)

==Clinical Features==
*[[Respiratory distress]]
*Hoarseness, [[dysphonia]], [[cough]], [[stridor]], [[dysphagia]]
*Subcutaneous emphysema
*Cervical ecchymosis
*[[Hemoptysis]]
*Tracheal deviation or abnormal laryngeal contour

==Differential Diagnosis==
{{Thoracic trauma DDX}}

==Evaluation==
''Investigate only once airway secure''
*Plain films, CT
**Air in soft tissues
**[[Pneumomediastinum]], [[pneumothorax]]
**[[cervical spine fractures and dislocations|Cervical spine fractures]]
**Hematomas, cartilage fractures
**Evaluate for other injuries

==Management==
===While preparing to secure airway===
*Mobilize specialists/back-up (ENT, cardiothoracics, surgery, anesthesia)
*Keep patient breathing spontaneously for as long as possible
*High-flow [[O2]]
*May by time with nebulized [[epinephrine]] and IV [[dexamethasone]]
*Anti-reflux medications (e.g. [[ranitidine]], [[metoclopramide]])
*[[Glycopyrrolate]] to reduce secretions

===''AIRWAY MANAGEMENT''===
''Avoid cricoid pressure!''
*Awake fiberoptic intubation
*Awake direct laryngoscopy/[[intubation]]
*Inhalational induction/intubation (keep patient breathing spontaneously)
*Awake tracheostomy
*Consider intubating through open wound if transected trachea visible

==Disposition==
*Admit

==See Also==
*[[Thoracic Trauma]]

==External Links==

==References==
<references/>

[[Category:Trauma]]
[[Category:Pulmonary]]