Emergency medicine clinics of North America
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Emerg. Med. Clin. North Am. · Aug 2007
ReviewEmergency department management of selected orthopedic injuries.
Rather than providing an encyclopedic review of extremity injuries, this article reviews selected serious injuries of the extremities that can be missed in the emergency department, either because they are relatively uncommon or because they are subtle in their clinical and radiographic presentation. They include injuries to the scapula, the shoulder, the forearm, the femur and hip, the knee, the tibia (which is the most common long bone fracture), and the ankle and foot. ⋯ Several of these injuries can result in emergent complications or have time-dependent outcomes. Consequently, these injuries often must be managed by emergency physicians before specialist expertise becomes available.
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Emerg. Med. Clin. North Am. · Aug 2007
ReviewPediatric major trauma: an approach to evaluation and management.
Trauma is the leading cause of death in children nationwide. Proper management of the pediatric trauma patient involves many of the components contained within standard trauma protocols. By paying strict attention to the anatomical and physiological differences in the pediatric population, clinicians will be assured the best possible outcomes. This article outlines the fundamentals of proper management of pediatric trauma patients.
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Pelvic fractures are associated with significant morbidity and mortality. Despite advances in emergency, radiologic, surgical, and ICU care that have improved survival during the past decade, the morbidity and the mortality remain significantly high. This article focuses on the recent developments in the initial management of pelvic fractures including the use of external pelvic binders, radiographic imaging, interventional radiology, and extraperitoneal packing.
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Emerg. Med. Clin. North Am. · Aug 2007
ReviewDiagnostic dilemmas and current controversies in blunt chest trauma.
Blunt chest injuries are common encounters in the emergency department. Instead of a comprehensive review of the management of all chest injuries, this review focuses on injuries that can be difficult to diagnose and manage, including blunt aortic injury, cardiac contusion, and blunt diaphragmatic injury. This review also discusses some recent controversies in the literature regarding the use of prophylactic antibiotics for tube thoracostomy and the optimal management of occult pneumothorax. The article concludes with a discussion of the management of rib fractures in the elderly.
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Emerg. Med. Clin. North Am. · Aug 2007
Optimal trauma outcome: trauma system design and the trauma team.
Trauma is the number one killer of Americans under age 34; optimal trauma care is provided when there is a well-functioning, comprehensive system. This article reviews the development of trauma centers in the United States, recommending that the number of trauma centers be optimized so that resources and expense be kept to a minimum. The role of specialists in the care of trauma patients has evolved over the past few decades. Efforts and protocols for trauma care should be based on objective quality outcome data, with the goal of making the most efficient use of resources for the best possible outcomes.