Emergency medicine clinics of North America
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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.
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Emerg. Med. Clin. North Am. · Feb 1998
ReviewThe emerging role of bedside ultrasonography in trauma care.
Ultrasonography has emerged as a primary imaging modality in the evaluation of the trauma victim. Both emergency physicians and surgeons have been proven capable of performing this rapid, noninvasive evaluation of the chest and abdomen. This article describes the trauma ultrasound examination and illustrates how bedside ultrasonography can be incorporated into routine trauma care.
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Penetrating injuries to the thoracoabdominal region represent a complex and diverse population of injuries. The clinician managing such cases must be able to consider all potential injuries, rapidly recognize life-threatening sequelae, and precisely diagnose and quickly manage these patients. The diverse nature of some of the potential presentations of patients with penetrating thoracoabdominal trauma is discussed. The most recent advances and controversies involving the evaluation and management of patients with penetrating thoracoabdominal trauma are also discussed.