Emergency medicine clinics of North America
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Emerg. Med. Clin. North Am. · May 2012
ReviewInitial management and resuscitation of severe chest trauma.
Severe chest trauma, blunt or penetrating, is responsible for up to 25% of traumatic deaths in North America. Respiratory compromise is the most frequent dramatic presentation in blunt trauma, while injuries to the heart and great vessels pose the greatest risk of immediate death following penetrating trauma. ⋯ This article reviews the presentation, diagnosis, and management of the most important thoracic injuries. A structured approach to the acutely unstable patient is proposed to guide resuscitation decisions.
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Pediatric respiratory illnesses are a huge burden to emergency departments worldwide. This article reviews the latest evidence in the epidemiology, assessment, management, and disposition of children presenting to the emergency department with asthma, croup, bronchiolitis, and pneumonia.
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Patients requiring airway management in the emergency department present an enormous challenge. It requires not only a firm concept of techniques for securing the airway but also of dealing with the potential difficult airway (DA) in which establishing a definite airway is not possible with techniques routinely used. This article highlights the importance of recognition and management of the DA in emergent situations. Both awake and nonawake intubation are discussed, and indications and guidelines are given for the use of nonsurgical and surgical airway interventions.
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Emerg. Med. Clin. North Am. · May 2012
ReviewInvasive and noninvasive ventilation in the emergency department.
This article reviews invasive and noninvasive ventilation for emergency physicians. It presents an overview of respiratory physiology principles that will help emergency physicians adapt their ventilation strategies to any clinical situation. ⋯ This review highlights a variety of ventilation strategies to be used for patients with normal lung mechanics and gas exchange, acute hypoxemic respiratory failure, decreased lung compliance, airflow obstruction, and weakness or restriction of the chest wall. This article will help clinicians prevent, recognize, and treat complications of mechanical ventilation.
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Emergency department presentations of pleural-based diseases are common, with severity ranging from mild to life threatening. The acute assessment, diagnosis, and treatment of pleural disease are critical as urgent invasive maneuvers such as thoracocentesis and thoracostomy may be indicated. The emergency physician must have a systematic approach to these conditions that allows for rapid recognition, diagnosis, and definitive management. This article focuses on nontraumatic pleural disease, including diagnostic and treatment considerations of pleural effusion, empyema, primary spontaneous pneumothorax, secondary spontaneous pneumothorax, pediatric pneumothorax, spontaneous hemothorax, and spontaneous tension pneumothorax.