Emergency medicine clinics of North America
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Of the three phases of disaster response, the primary phase (immediate postincident to six hours thereafter) represents the core of the EMS-augmented response to save lives. Activities during this phase include triage, victim control and stabilization, communications, and transportation. To cope successfully with the mass casualties of an actual disaster, special emergency forces must be trained (and rehearsed) to act together as a team to treat the critically ill and injured.
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This article focuses on some of the more common dangerous plant and mushroom ingestions, discussing toxic components, early symptoms, and treatment. Among the plants considered are oleander, foxglove, hemlock, dieffenbachia, and Amanita phalloides. Details concerning recognition of toxic species are intentionally omitted in an effort to avoid potentially dangerous errors in identification.
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Cold injuries, hypothermia, and frostbite are discussed, including the pathophysiology, clinical presentation, and modern management.
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Submersion injuries are a relatively common problem for emergency physicians. The primary physiologic problem in these patients is hypoxemia, and virtually all complications are secondary to this. ⋯ Despite prompt and vigorous resuscitation, though, residual neurologic deficits and deaths continue to occur after submersion injury. Clearly, prevention is the most important factor in reducing the morbidity and mortality from these injuries.
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This discussion focuses on the several pressure-related syndromes that are peculiar to diving and that are collectively known as dysbarism. These include barotrauma of descent, barotrauma of ascent, and air embolism. Also considered are nitrogen narcosis and decompression sickness.