Neck

The examination of the neck in the secondary trauma survey should cover the:

• cervical spine:
  • always assume a cervical fracture until clinical and imaging evidence to the contrary
  • inspect and palpate with in-line immobilisation in a neutral position
  • consider plane films and further imaging, eg CT scanning, on the guidance of a radiologist
• trachea; confirm that central; deviation may indicate mediastinal shift secondary to (haemo-)pneumothorax
• neck veins; engorged veins may indicate cardiac tamponade
• skin; penetrating injuries deep to platysma require operative investigation or imaging with angiography