Postgraduate medicine
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Postgraduate medicine · Feb 1987
Headache caused by serious illness. Evaluation in an emergency setting.
Severe headache is a common problem among patients in the emergency facility. Because early therapy reduces deaths from subarachnoid hemorrhage, the physician must use advanced technological and sometimes invasive tests to diagnose this serious condition in patients with equivocal signs and symptoms. In patients with meningitis, the physician must assume there will be only one opportunity to make the correct diagnosis. Because patients often seek emergency care early in the course of meningitis, when accurate detection on clinical grounds is more difficult, a conservative approach and liberal use of all appropriate diagnostic techniques are essential.
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Postgraduate medicine · Feb 1987
Historical ArticleCardiopulmonary resuscitation. Historical and future perspectives.
Although cardiopulmonary resuscitation (CPR) has been practiced for over a century, further study into methods for reviving victims of cardiac arrest is obviously needed. We now know that standard external CPR has numerous drawbacks, and modifications must be tested in a careful, randomized fashion. Three alternatives to standard external CPR (simultaneous compression-ventilation, interposed abdominal compression, and open-chest CPR) are currently being investigated. ⋯ Research must continue into ways of providing rapid advanced cardiac care, such as home defibrillators or rapid prehospital response to the victims of cardiac arrest by those trained in advanced cardiac life support (ACLS). In addition, to counteract the problem of neurologic demise after prolonged anoxia, study of postresuscitative care must continue. Only through the combination of these measures will survival rates after cardiac arrest improve.
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Postgraduate medicine · Jan 1987
ReviewCurrent issues in transfusion therapy. 2. Indications for use of blood components.
Many factors have stimulated a recent renewal of interest in indications for and use of blood components, including red blood cells, platelets, fresh-frozen plasma, cryoprecipitate, and granulocyte concentrates. Laboratory test results often provide helpful guidelines for the decision to use blood components. In this era of cost consciousness, the most important consideration still is to treat the patient in the most expedient and beneficial way. A conservative approach with an emphasis on high-quality medical practice is to choose and use blood components with consideration of both clinical information and laboratory findings.
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Postgraduate medicine · Oct 1986
Emergency management of hand injuries. When to repair, when to refer.
The primary care physician can accurately diagnose hand injuries by obtaining a thorough patient history and performing a complete physical examination of the hand. When the severity of injury is doubtful, immobilization in a splint with next-day referral is appropriate. Immediate consultation should be obtained with nerve or vascular damage, fracture-dislocation injuries, open fractures, substantial skin loss, or flexor tendon injuries at or distal to the wrist.