Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Tidsskr. Nor. Laegeforen. · May 1992
[Decision to withdraw cardiopulmonary resuscitation at Norwegian hospitals].
We present a survey on the use of do-not-resuscitate orders in Norwegian hospitals based on mailed questionnaires. 559 doctors, at least one from every somatic hospital in Norway responded. Do-not-resuscitate orders were issued by 92% of these doctors. There were large differences, however, as to who made the decision, who was involved in the decision-making, the consequences of a do-not-resuscitate order, and how the orders were documented. Formal rules for do-not-resuscitate orders are needed.
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The severity of injury inflicted by a missile is determined by the structure hit and retardation of the missile and thus the energy dissipated to the tissue. The injury to tissue depends on the kinetic energy and the construction of the missile, and the density and resilience of the tissue. Devastating, heavily contaminated wounds are inflicted by close-range shotguns and high-energy missiles, and thorough wound debridement and delayed primary closure are required after about four days. ⋯ This injuries primarily hollow organs such as lungs and intestines. Casualties from blasts may exhibit no external symptoms or signs of lung or intraabdominal injury. It is necessary to perform serial physical examinations, blood gas analyses, chest X-ray or CT scan.