JAAPA : official journal of the American Academy of Physician Assistants
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Organ transplantation has enriched and prolonged the lives of many patients who otherwise would have died of organ failure. Many of these advances, which occurred in the later part of the 20th century, are due to improved techniques and pharmacological management. ⋯ However, donor and recipient criteria can vary widely according to the organ(s) in question. This article reviews the historical changes that have occurred in transplant along with current criteria for donors and recipients, and describes the newest outreach to increase the donor pool.
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Severe sepsis is a continuum of physiologic stages characterized by infection, systemic inflammation, and hypoperfusion leading to tissue injury and organ failure. The primary goal of sepsis treatment is to prevent morbidity and mortality. Crystalloids are now recommended over colloids for volume resuscitation, one of the key interventions for patients with sepsis.
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Most pediatric ED visits are for nonemergent problems. Physician assistants are well trained to manage these patients; however, their effect on patient flow in a pediatric ED is unknown. ⋯ With restricted autonomy, PAs mainly benefitted the high-acuity patients. Increasing the level of PA autonomy was critical in broadening the effect of PAs to all acuity levels.
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Compartment syndrome is a fairly common condition noted in patients with fractures or crush injuries to the extremities (acute compartment syndrome) and in athletes (chronic compartment syndrome). Compartments bound by fascia are found in the extremities, buttocks, and abdomen; conditions that cause intracompartmental swelling and hypertension can lead to ischemia and limb loss. This article reviews diagnosis of the problem, monitoring of compartment pressure, and appropriate treatment.