Penetrating injuries of the neck. Emergency evaluation and management.

The physician who is called upon to attend to a penetrating wound to the neck must set priorities in management. (1) Establish a safe airway. (2) Maintain adequate cardiocerebral perfusion. (3) Assess and identify the type and severity of the wound so that proper decisions can be made about further evaluation and/or transfer for immediate surgical intervention. All this can be accomplished in an orderly fashion by applying the principles for selective surgical exploration of neck wounds outlined in this article. A well-reasoned approach can help avoid unnecessary surgery and yields a high likelihood of recovery.