Getting hit in the throat, whether by a fall, a sports accident, or an assault, constitutes blunt force trauma to the neck requiring immediate attention. This area houses the larynx (voice box) and the trachea (windpipe), both made of cartilage and highly vulnerable to injury. A hard blow can fracture these structures or cause rapid soft tissue swelling, quickly leading to a life-threatening airway obstruction. Recognizing severe injury signs and acting promptly is crucial, as breathing stability can deteriorate rapidly following trauma.
Critical Signs Requiring Immediate Medical Attention
Specific symptoms warn that the airway has been compromised and require immediate emergency medical services (EMS). The most concerning sign is noisy breathing, medically termed stridor, which is a high-pitched, harsh sound indicating a partial upper airway obstruction due to swelling or structural collapse. Difficulty breathing or respiratory distress, such as rapid, shallow breaths, signals a severe problem with oxygen intake.
Changes in the voice are also a major red flag, including hoarseness (dysphonia), a raspy quality, or a complete inability to speak (aphonia). This suggests damage to the vocal cords or the nerves controlling the larynx. A rapidly expanding swelling or hematoma on the neck is dangerous because it can compress the airway and major blood vessels.
Another specific sign is subcutaneous emphysema, which is air trapped under the skin that feels like a crackling or popping sensation when touched. This crackling suggests air has leaked from a tear in the trachea or larynx into the surrounding tissue. Other serious indicators of internal injury include coughing up blood (hemoptysis) or frothy sputum, and an obvious deformity or tenderness in the neck.
Immediate Steps for First Aid and Stabilization
Upon noticing any critical signs of distress, immediately call 911 or your local emergency number to mobilize professional help. While awaiting paramedics, the highest priority is maintaining the airway and preventing further injury, especially to the cervical spine. Keep the person still and minimize movement of the head and neck, treating the situation as if a spinal cord injury has occurred until professionals can rule it out.
If the person is conscious and breathing, gently encourage them to remain calm and still, ideally lying flat on their back. Closely monitor their breathing rate and level of alertness. If the person is unconscious or begins vomiting, carefully roll them onto their side into a recovery position to prevent aspiration, maintaining stabilization of the head and neck as a single unit.
Never attempt to force the neck straight or move the person unless absolutely necessary to prevent immediate danger. Do not give the injured person anything to eat or drink, as this could lead to aspiration or complicate potential emergency surgery. If there is an open wound with bleeding, apply direct pressure with a clean cloth or gauze, ensuring the pressure does not obstruct breathing. Continually reassure the person and observe for sudden changes, reporting any increased difficulty breathing or loss of consciousness to the dispatcher.
Hospital Procedures and Follow-Up Care
Professional medical evaluation is non-negotiable, even if initial symptoms appear mild, due to the potential for delayed swelling and injury progression. Patients are monitored closely for 24 to 48 hours, sometimes in intensive care, because edema (swelling) can increase and obstruct the airway later. The immediate goal is to secure a stable airway, which may involve a surgical procedure like a tracheotomy if the airway is completely blocked or rapidly collapsing.
Diagnostic imaging includes a Computed Tomography (CT) scan of the neck to visualize the laryngeal and tracheal cartilages, identify fractures, and detect air leakage. Doctors perform a flexible laryngoscopy, inserting a thin, lighted tube through the nose to directly view the vocal cords and the extent of internal damage. Severe fractures may require surgical intervention to realign and stabilize the cartilage with wires or plates.
Follow-Up Care
Following stabilization, follow-up care with specialists, such as an Otolaryngologist (ENT doctor), is necessary to assess long-term function. Patients with laryngeal injuries may require voice rest, humidified air treatments, and specific medications to reduce swelling and acid reflux. Depending on the damage severity, rehabilitation involving speech and swallowing therapy may be needed to fully recover vocal quality and normal function.