Emergency medicine clinics of North America
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Submersion injuries are a major cause of morbidity and mortality in children and young adults. The Emergency Department physician should be familiar with the epidemiology, pathophysiology, modes of therapy, and prognostic indicators in order to provide optimum resuscitation to the near-drowning victim, correct referral, and counseling to their families.
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Chest trauma will continue to be a significant cause of acute respiratory distress. It is a major source of morbidity and mortality in otherwise healthy young people. Airway control, oxygenation, drainage of pneumothoraces and hemothoraces and fluid resuscitation are the cornerstones of therapy. With these basic maneuvers, most chest trauma patients can be treated successfully.
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ARDS is a pulmonary injury syndrome associated with a variety of clinical disorders. The pathophysiology of ARDS has been clarified substantially in the past several years. ⋯ The mortality rate in ARDS remains high despite advances in elucidating of pathogenesis. Newer approaches to management stress earlier identification of patients and specific therapy aimed at interfering with the damage produced by toxic mediators of pulmonary injury.
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This comprehensive article reviews some of the most common injuries to the ear, nose, and throat, and in addition reviews the relative anatomy of this area of the body. Particular attention is paid to the treatment of the patient with epistaxis, a common presentation to the Emergency Department.
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NGT insertion is a procedure that is done frequently in Emergency Departments. A step-by-step procedure has been presented. There are certain circumstances that may make NGT insertion difficult. ⋯ Complications, although rare, may occur. Examples of complications that are reported in the literature include mucosal ulcerations, submucosal passage of a tube, accidental passage of an NGT into the brain, and esophageal perforation. Generous lubrication, direct visualization, and the use of fluoroscopy, as well as knowledge of these complications, may help to decrease or prevent their incidence.