A patient is brought to the emergency department with a penetrating wound to the neck. The patient is dyspneic and cyanotic and has evidence of subcutaneous emphysema. What does the nurse expect the physician to do initially?
1. intubate the patient because of the severe wound
2. notify the next of kin regarding the patient's condition
3. order x-rays of the lumbar area to assess for fractures
4. administer a beta blocker to alleviate the sympathetic response
Correct Answer: 1
Penetrating trauma to the neck is associated with a high degree of morbidity and mortality. Airway involvement includes dyspnea, cyanosis, subcutaneous emphysema, hoarseness, or air bubbling from the wound. The key is early identification of the need for intubation before the patient has no airway at all. The physician will most likely do or prescribe the other options; however, the most important is to maintain the airway.
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