Travers Benjamin, Dearden Rachel, Jones Shanna, Opsommer Michael
Oakland University William Beaumont School of Medicine, Rochester, MI.
Beaumont Health System, Department of Emergency Medicine, Troy, MI.
J Educ Teach Emerg Med. 2020 Jan 15;5(1):V15-V19. doi: 10.21980/J8V926. eCollection 2020 Jan.
This report describes a unique presentation of stridor in an elderly patient who presented to the emergency department (ED) with neck and back pain after a fall down a flight of stairs. The patient had no airway issues on initial evaluation in the resuscitation room, but developed stridor and respiratory distress after returning from imaging. The unexpected stridor and respiratory distress were alleviated with basic airway maneuvers that included airway repositioning and a breathing treatment. Cervical computed tomography (CT) showed a cervical fracture and a retropharyngeal hematoma, which was responsible for the partial obstruction of this patient's upper airway leading to delayed stridor. Following management of the respiratory distress, the patient was diagnosed with and treated for central cord syndrome. The key takeaway from this case is that there should be a low level of suspicion for impending upper airway compromise in elderly patients presenting to the ED with a cervical spine injury.
Stridor, retropharyngeal hematoma, cervical spine fracture, central cord syndrome.
本报告描述了一名老年患者出现喘鸣的独特情况。该患者从一段楼梯上摔倒后,因颈部和背部疼痛前往急诊科(ED)就诊。患者在复苏室进行初始评估时没有气道问题,但在做完影像学检查返回后出现了喘鸣和呼吸窘迫。通过包括气道重新定位和呼吸治疗在内的基本气道操作,缓解了意外出现的喘鸣和呼吸窘迫。颈椎计算机断层扫描(CT)显示颈椎骨折和咽后血肿,这是导致该患者上气道部分梗阻并引发延迟性喘鸣的原因。在对呼吸窘迫进行处理后,患者被诊断为中央脊髓综合征并接受了治疗。该病例的关键要点是,对于因颈椎损伤前往急诊科就诊的老年患者,应高度怀疑其即将出现上气道受损情况。
喘鸣、咽后血肿、颈椎骨折、中央脊髓综合征。