Emergency medicine clinics of North America
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Penetrating neck trauma can pose significant diagnostic and therapeutic challenges for emergency physicians. Factors contributing to these problems are complex anatomy, proximity of vital structures, and potential for rapid deterioration of airway, vascular, or neurologic injuries. ⋯ This review focuses on the key components of the history and physical examinations that allow for an assessment of the severity and type of structures involved. In addition, current methods of airway management, as well as ways to manage penetrating neck trauma efficiently and cost effectively, are discussed.
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Proper management of the pediatric trauma patient involves most of the components contained within standard trauma protocols. By paying strict attention to the anatomical and physiological differences among the pediatric population, the clinician will be assured the best outcomes. This article outlines the fundamentals of proper management of pediatric trauma patients.
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The primary goal in caring for the traumatized patient is to provide effective resuscitative interventions while minimizing the time from injury to definitive care. The emergency physician is often called on to provide initial stabilization and resuscitation, which is done most effectively if one is well versed in trauma care and has an organized approach to the multiply injured patient. This article discusses several current controversies in the emergency care of trauma patients.
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Emerg. Med. Clin. North Am. · Feb 1998
ReviewDiagnosis and management of penetrating vascular trauma and the injured extremity.
Early diagnosis and timely treatment of extremity vascular injuries are essential if limb salvage and limb function are to be optimized. Careful and repeated clinical examination and ankle/brachial doppler indices are pivotal for early diagnosis. ⋯ An algorithm for the diagnostic evaluation and treatment of patients with penetrating extremity trauma is presented. The early diagnosis of compartment syndrome is stressed.
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The importance of cerebral perfusion pressure (CPP) optimization has been recognized in the neurosurgical community in the United States as part of the recently published Guidelines for Management of Severe Head Injury. Although further basic and clinical research is needed before a CPP-directed head injury management standard of care is formulated, optimization of CPP is practical with present personnel and equipment resources in many emergency departments. Emergency Department physicians should be familiar with CPP management principles to facilitate interactions with neurosurgical colleagues and improve patient outcomes.