Heizmann et al proposed a management strategy for a patient with blunt trauma to the thyroid gland. The authors are from University Hospital Basel in Switzerland.
Patient selection: blunt trauma to the thyroid gland suspected
Evaluation is based on physical examination and a contrast-enhanced CT scan
Parameters:
(1) grade of traumatic injury
(2) hemodynamic stability
(3) presence of associated injuries
(4) presence of associated thyroid pathology
Grade
Hemodynamic Stability
Associated Injuries
Thyroid Pathology
Management
I or II
stable
none
none
conservative; observe; follow with neck ultrasound
I or II
stable
none
present
elective neck exploration with gland repair
III or IV
NA
present
NA
emergency management
NA
present
NA
NA
emergency management
Emergency management may include:
(1) orotracheal intubation if the airway is compromised
(2) neck exploration with evacuation of hematoma and repair of any associated injuries to the thyroid gland, larynx, trachea, major blood vessels and possibly the esophagus
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