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CHAPTER 112 ■ NECK TRAUMA GEORGE A (TONY) WOODWARD, ASHLEY E KEILMAN GOALS OF EMERGENCY CARE Pediatric neck injuries are uncommon; but many children are routinely evaluated for injuries after trauma Because neck injuries can be life threatening, including those that are subtle on presentation, children with neck trauma need to be assessed in a timely and orderly manner with a high index of suspicion The goals of emergency care are to ensure a patent airway with adequate oxygenation and ventilation, control hemorrhage, maintain spinal stability, and identify and prevent progression of all injuries A listing of common mechanisms of neck injury is given in Table 112.1 This chapter will discuss the evaluation and management of penetrating and direct blunt injuries, as well as the evaluation of the cervical spine taking into consideration the unique features that differentiate pediatric from adult neck anatomy and physiology KEY POINTS Pediatric neck injuries are uncommon Children have unique anatomic differences and mechanisms of injury that contribute to characteristic patterns of injury that vary from adults Multiple structures within the neck and cervical spine are at risk for injury; knowing their anatomic relationships will help guide the emergency evaluation Management priorities are first to ensure a patent airway, adequate respiration, control of hemorrhage, and spinal stabilization and second to identify and prevent progression of all injuries RELATED CHAPTERS

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