A 19-year-old man is brought to the emergency department with a stab wound at the base of the neck (zone I) (Figure below). The most important concern for patients with such injuries is which of the following?For the purpose of evaluating penetrating injuries, the neck is divided into three zones. Zone I is below the clavicles and is also known and the thoracic outlet. Zone II is located between the clavicles and hyoid bone, and Zone III is above the hyoid.
Exsanguinating hemorrhage is the predominant risk, because bleeding may not be easily recognized, given that bleeding into the pleural cavity and mediastinum can occur. The abundant collateral blood supply generally protects against upper extremities or cerebrovascular compromise.
Upper extremity ischemia
Cerebral infarction
Exsanguinating hemorrhage
Mediastinitis
Trauma