Traumatic asphyxia may occur after a severe crush injury to the chest caused by impact of a heavy object. This is related to a rise in venous pressure in the superior vena cava associated with increased intrathoracic pressure.


Clinical findings:

(1) cyanosis and petechiae over head, neck and upper torso

(2) facial edema

(3) subconjunctival hemorrhage

(4) occasional neurologic symptoms associated with cerebral edema (loss of consciousness, seizures, confusion)

(5) occasional visual disturbances (temporary or permanent blindness)


Differentiation from generalized cyanosis:

(1) persists after oxygen supplementation

(2) limited to head and neck


Common associated injuries:

(1) hemothorax

(2) flail chest

(3) ruptured diaphragm with visceral herniation


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