Airway trauma

Learning objectives

A life-threatening condition resulting from blunt and penetrating injuries to the neck and chest, as well as from medical procedures that may injure the airway
Maxillofacial, neck, or laryngeal trauma
Airway obstruction or obstruction by blood, secretions, tissue edema, debris, and vomitus
Airway trauma can be associated with cervical spine injury which will worsen during intubation

Neck pain
Hoarseness
Dysphagia
Cough
Dysphonia
Laryngeal dyspnea
Loss of consciousness
Stridor
Cyanosis
Hypoxemia
Hamman’s sign or a mediastinal crunch (a crunching, rasping sound, heard over the precordium in mediastinal emphysema)

Anatomical territory	Associated problems	Caution: red flag signs and symptoms
Maxillofacial	Traumatic brain injury and base of skull fracture Cervical spine fracture Ophthalmic injury Vascular injury Pulmonary aspiration of blood and debris	Signs of Increased intracranial pressure Neurological deficit Neurogenic shock Significant bleeding from fracture displacement Bilateral anterior mandible fractures and airway obstruction Ventilatory failure
Laryngotracheal	Cervical fracture Vascular injury Oesophageal injury Rib fractures and flail segment Pneumothorax Haemothorax Pneumomediastinum Pulmonary contusion	Massive hemoptysis and stridor have previously been reported as cardinal features of severe laryngotracheal trauma Massive surgical emphysema Ventilatory failure Cardiovascular collapse
Trachea and bronchi	Vascular injury Oesophageal injury Rib fractures and flail segment Tension pneumothorax Hemothorax Pneumomediastinum Pulmonary contusion	Massive hemoptysis Massive surgical emphysema Ventilatory failure Cardiovascular collapse