Traumatic Emergencies Involving the Pediatric Airway

Mandell, David L.

doi:10.1016/j.cpem.2004.12.004

Cited by 11 publications

(8 citation statements)

References 31 publications

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“…Compared to adults, children are less likely to be involved in motor vehicle accidents and violent altercations. Anatomically the pediatric larynx is located higher in the neck, allowing the mandibular arch to protect the larynx . Additionally, the laryngeal cartilages in children are more pliable, decreasing the likelihood of laryngeal fractures.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, the laryngeal cartilages in children are more pliable, decreasing the likelihood of laryngeal fractures. However, the narrower lumen of the pediatric airway and loose attachment of mucosa to underlying laryngeal cartilages in children increases the risk of soft tissue damage, edema, and hematoma formation resulting in airway obstruction .…”

Section: Discussionmentioning

confidence: 99%

“…The mechanisms of laryngotracheal injuries from blunt neck trauma include : Rapid deceleration of a motor vehicle, causing an unrestrained passenger to be thrown forward, usually with the head extended and the neck collides with the steering wheel or dashboard, crushing the laryngeal and/or tracheal cartilages against the cervical vertebrae. Clothesline injuries to the neck while riding motorcycles, all‐terrain vehicles, or snowmobiles when the rider strikes a stationary object such as a wire fence or tree limb. Clothesline injuries can also occur in high contact sports and martial arts. Direct trauma to the neck from interpersonal violence (direct blows using fists, feet, or blunt weapons). Strangulation from hanging, ligature suffocation, or manual choking. Blunt chest trauma causing antero‐posterior compression, resulting in sudden increase in transverse diameter of the chest, lateral traction on the trachea, and linear rupture. …”

Section: Discussionmentioning

confidence: 99%

“…The etiology of blunt neck trauma in children is age dependent. In younger children, common etiologies include falls onto furniture or bicycle handlebars with the neck extended, causing compression of the larynx and trachea against the vertebral column . Among adolescents, the etiology is similar to adults and includes motor vehicle accidents, sports injuries, and clothesline injuries .…”

Section: Discussionmentioning

confidence: 99%

“…A detailed history of the mechanism of injury along with a description and duration of symptoms must be obtained. Presenting symptoms are varied and range from mild dysphonia and hoarseness of voice to stridor and acute respiratory distress . Other symptoms include dyspnea, dysphagia, anterior neck pain, hemoptysis, and cough.…”

Section: Discussionmentioning

confidence: 99%

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Airway management in laryngotracheal injuries from blunt neck trauma in children

Chatterjee

Agarwal

Bajaj

et al. 2015

Pediatric Anesthesia

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Pediatric laryngotracheal injuries from blunt neck trauma are extremely rare, but can be potentially catastrophic. Early diagnosis and skillful airway management is critical in avoiding significant morbidity and mortality associated with these cases. We present a case of a patient who suffered a complete tracheal transection and cervical spine fracture following a clothesline injury to the anterior neck. A review of the mechanisms of injury, clinical presentation, initial airway management, and anesthetic considerations in laryngotracheal injuries from blunt neck trauma in children are presented.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Airway management in laryngotracheal injuries from blunt neck trauma in children

Chatterjee

Agarwal

Bajaj

et al. 2015

Pediatric Anesthesia

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Observation of tardive laryngeal edema after blunt trauma to the neck is not necessary: a 10-year retrospective analysis

Hermansen

Bilde

Rasmussen

2009

Eur Arch Otorhinolaryngol

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Patients exposed to blunt laryngeal trauma not requiring immediate attention are usually observed for 24 h in the ward due to the risk of airway obstruction. In some cases without laryngeal edema on initial examination, edema may develop later. This condition is defined as tardive laryngeal edema (TLE) as opposed to progressive laryngeal edema, where the edema is present initially. Though specialists internationally report on TLE-even with severe airway obstruction-we could not find any publications describing it, and the specific definition seems to be used only in Denmark. In order to identify cases of TLE at our clinic a retrospective study over a period of 10 years was undertaken. Of 145 patients included, 6 developed insignificant TLE. None of the patients developed life-threatening TLE. The results of this study indicate that TLE is a rare condition and we suggest that severe life-threatening TLE does not exist. We propose that patients with no laryngeal edema on first examination and with no laryngeal fractures can safely be discharged after primary examination.

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