Primary care
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The preceding discussion is an attempt to stress anatomy in the diagnosis of coma. By localizing the offending lesion, the physician can apply the appropriate diagnostic and therapeutic measures more adeptly. Because physicians are also frequently asked to prognosticate, I have tried to summarize the work of Plum and Posner in their study of the outcome of patients presenting in coma. The primary care physician is encouraged to plan at least for the basics in case he or she is faced with a comatose patient.
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Careful telephone triage of women with significant obstetric and gynecologic emergencies is the optimal way to avoid devastating complications in the office. With practical knowledge and some specialized office equipment and medications, most obstetric and gynecologic emergencies can be managed effectively in the office or stabilized while arranging transport to a hospital. Management of the most common complications likely to be encountered is outlined in this article.
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The care of the trauma patient is a complex undertaking involving multiple health care professionals and represents one of the greatest challenges to any physician. There is perhaps no greater opportunity to have a positive impact on patient care than in the care of these patients. ⋯ With proper motivation and experience, the physician's care of trauma patients will continually improve. This will lead to a rewarding experience for the patient and the physician alike.
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This article is intended as an overview of emergencies that could and often do present to the physician's office, especially when a hospital emergency department may not be nearby. It is not intended as an in-depth view of every problem but should be considered as a presentation of essential management in the emergency phase of treatment. The reader is directed to the references for more in-depth information on these topics.