Otolaryngologic clinics of North America
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Otolaryngol. Clin. North Am. · May 1979
The initial evaluation of the patient with multiple injuries.
The management of trauma patients requires organization and the cooperation of trained health personnel, beginning at the site of injury and continuing until the patient is discharged from the hospital. Treatment guidelines and priorities must be well outlined in advance to provide optimal care and minimize delay prior to definitive therapy. Resuscitation and treatment must begin immediately and simultaneously following well established principles. These guidelines and the general care of the patient with multiple trauma are discussed in this article.
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Because of the large numbers of head injuries, physicians are frequently called upon to evaluate and initiate treatment in these acute emergencies. Deterioration of such patients results from direct injury to the brain tissue and a subsequent increase in the intracranial pressure. The pathophysiology of brain injury is manifested in a cycle of detrimental events with increased tissue damage and progressive neurological deficit. Current concepts in management of head injuries aimed at interrupting this cycle of events are discussed in detail.
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The differential diagnosis between the usual acute otitis externa and acute suppurative otitis media is presented. Other important and sometimes frequently seen entities that present as infections in the ear are also discussed. It is emphasized that a patient complaining of ear pain with normal findings on examination must be more thoroughly investigated because of the possibility of a more ominous condition such as carcinoma of the pharynx.