Southern medical journal
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To understand fully a physician's role in society, and to deal successfully with the current sense of crisis, the medical profession must evolve a world-view that appropriately relates a physician to the patient, to the practice environment, to the base of knowledge, and to the physician's own sense of self. Such a world-view would be multilevel and interdisciplinary, and would be based on interactions and adaptations of physicians to life systems. Medicine's world-view must provide a philosophic milieu intérieur that leads to a proper equilibrium between medicine's technologic skills and its humanistic concerns.
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Southern medical journal · Dec 1988
Review Case ReportsBlunt injuries of the cervical trachea: review of 51 patients.
The low incidence of blunt trauma to the cervical portion of the trachea limits management experience in most centers. Hence, we combined our patients with those in published reports containing essential information on injury, treatment, and results. Among 51 patients (93% male), ages ranged from 3 to 65 years. ⋯ Two patients died of other injuries, and six patients (four with delayed repair) required subsequent tracheal reconstruction. Repair over a stent was used in seven patients, four of whom had satisfactory results. From this review we conclude that (1) the diagnosis of blunt trauma to the cervical trachea requires a high index of suspicion, since this injury can easily be overlooked; (2) tracheostomy (vs intubation or cricothyroidotomy) is the preferred means of airway control; (3) preoperative laryngoscopy/bronchoscopy should be done to assess vocal cord function, possible laryngeal damage, and level of tracheal injury; (4) good long-term results, measured by voice and airway quality, are best obtained by immediate repair of significant injuries.
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Southern medical journal · Dec 1988
Pediatric prehospital care in a southern regional emergency medical service system.
A retrospective review of 2,302 ambulance run reports from the Birmingham Regional Emergency Medical Service System indicated that 6% of all runs are for patients in the pediatric age group (less than 18 years of age). Injuries related to emergencies were responsible for more than 65% of pediatric runs, and 30% were related to motor vehicle accidents. Surprisingly, 8% of calls were for seizure disorders, a figure much higher than in the adult population. ⋯ Significantly more male than female patients were involved. This descriptive epidemiologic study is antecedent to effective planning and implementation of pediatric prehospital care programs. Training of emergency personnel should be targeted toward treating motor vehicle injuries, seizures, poisoning, and upper airway obstruction in children.