Articles: critical-care.
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Each year, some 12,000 Americans are rendered paraplegic or quadriplegic by spinal cord injury. Most of these injuries result from motor vehicle accidents, falls, and sports-related trauma. ⋯ The following article has been prepared to help clinicians understand and manage patients with spinal cord injuries. It reviews the pathophysiology of spinal cord trauma, especially that involving the cervical region, and discusses the treatment of this condition from a critical care, rather than a neurosurgical, point of view.
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Prehospital resuscitation and stabilization of major trauma victims is increasingly employed. To evaluate the benefits of one such maneuver, fluid administration, we reviewed 52 consecutive trauma cases in which patients had a blood pressure of less than 100 mm Hg either at the scene or on arrival to hospital. ⋯ A percentage of patients with correctable surgical lesions might have been salvaged had prompt transport been instituted. Field maneuvers in critically injured patients should be minimized to decrease ultimate mortality.