Postgraduate medicine
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Flooding of the lungs occurs routinely in drowning victims. The cause of death in 90% of them is hypoxemia caused by water in the lungs. Mouth-to-mouth ventilation is ineffective until the water is removed. ⋯ It is an especially useful technique because fear of contagion sometimes deters rescuers from using mouth-to-mouth ventilation. Further treatment has not been necessary in most instances. If the victim does not recover after water ceases to flow from the mouth, ventilation techniques, cardiopulmonary resuscitation, and other measures as indicated should be used.
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The cause, depth, and location of a laceration are major determining factors in its treatment. In all cases, the wound must be completely cleansed with irrigation under pressure and then examined radiographically if necessary and debrided. Successful repair depends on understanding and using the principles of wound healing. ⋯ Full-thickness sutures may safely be used only on palmar and plantar surfaces. With an extensive laceration or one near a joint, a splint or sling may be needed. The wound should be examined a couple of days after suture placement for signs of infection.
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Postgraduate medicine · Mar 1988
Common fractures of the extremities. How to recognize and treat them.
Primary care physicians are called on to see and treat a variety of orthopedic problems, including the common fractures discussed in this article. They must recognize the fractures they feel comfortable in treating and differentiate those that should be referred to someone with more experience in complex fracture care. The goal of treatment is to restore optimal function without deformity.
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Current therapeutic options make office management of the patient with uncomplicated left-sided ulcerative colitis or mild to moderate Crohn's disease quite feasible for the primary care physician. On the horizon are additional drugs that will enhance the physician's ability to treat patients with inflammatory bowel disease effectively, with minimal risk of side effects or toxicity.