Articles: trauma.
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To discuss the clinical indications and complications of non-invasive ventilation. ⋯ Non-invasive ventilation using the modes of CPAP, PSV, BiPAP and NIPPV should be considered in patients with respiratory disorders who remain in acute respiratory failure despite conventional therapy, before considering invasive mechanical ventilation.
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Africa's first conference on emergency medicine was held in October 1998 in Johannesburg, South Africa. Attended by 305 delegates from 13 countries, it was an important milestone in the development of Africa, emergency medicine's last frontier. ⋯ A session reviewing the activities of traditional healers was not only terrifyingly revealing, it also upset and offended a segment of the African audience. The conference ended positively with the creation of the Emergency Medicine Society of South Africa, a step toward recognition of emergency medicine as a specialty in Africa.
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To consider the evidence for the beneficial effects of the current management guidelines in traumatic brain injury, and to highlight the important issues. ⋯ The impact of management guidelines in traumatic brain injury on patient outcome has been difficult to determine. However, there is a large body of uncontrolled evidence that suggests secondary global cerebral ischaemia-hypoxic insults are the major determinants in influencing outcome and that therapeutic interventions that maintain and defend cerebral perfusion pressures may improve outcome.
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To review the indications and complications of the percutaneous tracheostomy compared with the standard surgical tracheostomy in the critically ill patient. ⋯ In the critically ill patient who requires a tracheostomy, the percutaneous rather than the standard surgical technique is the method of choice as it can be performed at the bedside, leaves a smaller scar after decannulation and may be associated with fewer complications compared with the standard surgical technique.