Hard and soft signs of penetrating neck injury

Hard signs of vascular injury*

Severe or uncontrolled hemorrhage

Large, expanding, or pulsatile hematoma

Thrills or bruits

Shock unresponsive to IV fluid resuscitation

Absent or diminished radial pulse

Neurologic deficit (eg, hemiplegia) consistent with cerebral ischemia

Hard signs of aerodigestive injury*

Air bubbling from a wound

Massive hemoptysis or hematemesis

Respiratory distress

Soft signs of injury

Proximity wounds

Minor hemorrhage

Mild hypotension responsive to IV fluid resuscitation

Minor hemoptysis or hematemesis

Subcutaneous or mediastinal air

Non-pulsatile, non-expanding hematoma

Dysphonia

Dysphagia

IV: intravenous.
*Hard signs of injury reflect the presence of a serious injury that generally requires immediate transfer to the operating room.

Graphic 106163 Version 2.0