Injury to the major airways.

Most patients with major airways injury die before reaching hospital. Successful treatment of initial survivors depends on procurement of a reliable airway, effective cardiopulmonary resuscitation, and prompt primary repair. In practice many tracheobronchial injuries are overlooked during the first 24 hours, resulting in death or prolonged debility. Early recognition requires a high index of suspicion in victims of blunt or penetrating trauma to the chest or neck.