Prolonged Field Care Podcast #9 of 2025 Top Ten: Penetrating Neck Trauma
Dec 22, 2025
The discussion highlights the unique challenges of neck and upper chest injuries in modern combat. Anatomy and zone classifications guide effective surgical interventions. Teamwork and swift decision-making are crucial for hemorrhage control and airway management. Real-world case studies underscore these techniques, including finger tamponade as a life-saving measure. The experts also stress the importance of training in trauma care and adapting responses to evolving injury patterns.
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Neck Zone Classification Matters
- The neck is divided into zones (1: sternal notch–cricoid, 2: cricoid–angle of jaw, 3: angle–base of skull) to guide surgical approach and urgency.
- Zone one injuries often imply chest involvement and may require sternotomy or thoracotomy for proximal control.
Hematoma Chokes Via Venous Congestion
- Neck hematomas cause airway compromise by venous and capillary congestion, not direct tracheal collapse.
- A growing neck hematoma is a ticking time bomb even if phonation is intact.
Prioritize The Airway With Hard Signs
- If a patient shows direct neck trauma, expanding hematoma, hoarseness or bleeding into the mouth, secure the airway immediately.
- Delay hemorrhage control only if the airway is stable and protected.