Journal of emergencies, trauma, and shock
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Critically ill patients are common in emergency medicine, and require expert care to maximize patient outcomes. However, little data is available on the provision of critical care in the ED. The goal of this study is to describe the management of critically ill patients in the ED via a survey of Canadian emergency physicians. ⋯ Our survey demonstrates that critically ill patients are common in Canadian ED's, and that EMP's are often responsible to provide care for prolonged period of time. In addition, the use of invasive procedures other then direct laryngoscopy was variable. Further research is warranted to determine the impact of delayed transfer and ED physician management of critically ill patients in the ED.
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J Emerg Trauma Shock · Oct 2011
Designing, managing and improving the operative and intensive care in polytrauma.
Polytrauma is a leading cause of mortality in the developing countries and efforts from various quarters are required to deal with this increasing menace. ⋯ There is an urgent need for proper implementation ofpre-hospital and advanced trauma life support measures at grass-root level. Analyzing the profile of polytrauma victims at a national level and simultaneously improving the trauma care services at every health center are very essential to decrease the mortality and morbidity. The improvement can be augmented further by strengthening the rural health infrastructure, strict traffic rules, increasing public awareness and participation and coordination among the various public and private agencies in dealing with polytrauma.
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J Emerg Trauma Shock · Oct 2011
Influence of prehospital fluid resuscitation on patients with multiple injuries in hemorrhagic shock in patients from the DGU trauma registry.
Severe bleeding as a result of trauma frequently leads to poor outcome by means of direct or delayed mechanisms. Prehospital fluid therapy is still regarded as the main option of primary treatment in many rescue situations. Our study aimed to assess the influence of prehospital fluid replacement on the posttraumatic course of severely injured patients in a retrospective analysis of matched pairs. ⋯ The high amounts of intravenous fluid replacement was related to early traumatic coagulopathy, organ failure, and sepsis rate.
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J Emerg Trauma Shock · Oct 2011
C-clamp and pelvic packing for control of hemorrhage in patients with pelvic ring disruption.
Exsanguinating hemorrhage is the major cause of death in patients with pelvic ring disruption. ⋯ Pelvic packing in addition to the C-clamp fixation effectively controls severe hemorrhage in patients with pelvic ring disruption. Early sequential measurements of blood lactate levels can be used to estimate the severity of shock and the response to the shock treatment.