American family physician
-
Blunt or penetrating trauma to the chest can cause several life-threatening conditions: open or closed pneumothorax, each with or without hemothorax; flail chest; pericardial tamponade, and injury to other structures in the chest--the esophagus, trachea or great vessels. Any trauma sufficient to compromise function of thoracic organs must also be suspect for extrathoracic injuries, especially to the spleen and other abdominal viscera.
-
Personal injury may result from deceleration of the body or of missiles by the body, resulting in blunt or penetrating multiple trauma. The extent of the deceleration injury is determined by the amount of energy absorbed. Whether the injury is blunt or penetrating depends on factors of force, surface and time. Priorities in the management of the multiple-injury patient consist of rapid evaluation and control of breathing, bleeding and shock.
-
Infiltration of local anesthetic agents to achieve analgesia for the repair of lacerations or the excision of large lesions requires multiple injections, uses large volumes of local anesthetic solution and frequently produces inadequate pain relief. Peripheral nerve blocks utilize a small number of precisely placed injections to anesthetize relatively large areas of the body. Many of these blocks are safe and easy to perform in an outpatient setting.