While riding a snowmobile, assessment reveals anterior neck abrasions after a neck-level impact. Which injury should the paramedic suspect?

• A. Basilar fracture
• B. Laryngeal fracture
• C. Tension pneumothorax
• D. Fracture of the manubrium

Answer: (B)

Anterior neck trauma with visible abrasions points to injury of the front structures in the neck, where the larynx sits. Blunt impact here can fracture the laryngeal cartilages, making a laryngeal fracture the most likely injury. This contrasts with basilar fractures ( skull base, not indicated by neck abrasions), tension pneumothorax (chest condition), or a fracture of the manubrium (upper sternum) which don’t align with anterior neck signs. So the finding of anterior neck abrasions after a neck-level impact bestSuggests a laryngeal fracture, a serious airway injury that requires careful airway management and close monitoring for evolving airway compromise.