Abstract：
:Prehospital management of musculoskeletal injuries in the traumatized patient is based on the application of a few basic principles in an orderly but expeditious manner. The patient must be assessed for immediate life-threatening conditions involving airway, respiratory, and circulatory functions while the cervical spine is protected. Resuscitative efforts to reestablish and preserve an adequate circulating volume of oxygenated blood must follow, using airways, oxygen therapy, and fluid replacement through MAST trousers and intravenous fluids. Cardiac function must be maintained as well. Respiratory function must be monitored and assisted as required. Finally, neurologic status must be assessed and monitored. Secondary assessment of all pertinent history and physical findings is made to delineate all other injuries that do not pose an immediate threat to the life or limb of the patient. Definitive care follows but is limited to basic resuscitation, stabilization, and immobilization techniques under medical control through telemetry and radio communication. Immediate definitive care of the traumatized patient requires the expeditious intervention of the trauma team in a hospital setting with surgical, blood banking, radiographic, laboratory, and other hospital-based capabilities available. Field management of the traumatized patient is directed at the expeditious delivery of the viable patient to the trauma team. In the multiply traumatized patient with severe injuries to several organ systems, prehospital care may need to be expedited to provide this patient the in-hospital care required to save his or her life. Appropriate treatment in such life-threatening trauma situations will consist of a rapid primary assessment, airway and cervical spine control, appropriate respiratory and cardiovascular assistance, gross whole body fracture immobilization using a backboard, and immediate transport. For less severely injured patients, primary assessment, resuscitation, stabilization, full secondary assessment, initial definitive care, and immobilization should be completed before transport begins.
journal_name
Emerg Med Clin North Amjournal_title
Emergency medicine clinics of North Americaauthors
Worsing RA Jrsubject
Has Abstractpub_date
1984-05-01 00:00:00pages
205-17issue
2eissn
0733-8627issn
1558-0539journal_volume
2pub_type
杂志文章,评审abstract：:The widely recognized benefits of early diagnosis and treatment of acute myocardial infarction (AMI) have only emphasized the importance of emergency physician (EP) competence in electrocardiographic interpretation. As such, the EP must be an expert in the interpretation of the electrocardiogram (ECG) in the emergency...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0733-8627(05)70185-1
更新日期：2001-05-01 00:00:00
abstract：:This article examines the role and impact of EMTALA on the ethical delivery of hospital-based emergency services, primarily through close inspection of three of the core EMTALA mandates: the medical screening examination, the duty to accept patients in transfer from less capable facilities, and the requirement that th...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2006.05.003
更新日期：2006-08-01 00:00:00
abstract：:Newer drugs of abuse, such as MDMA, GHB, GBL, 1,4-BD and ketamine, are frequently used in the settings of raves and are often promoted on the internet. The popularity of these agents is increasing; therefore, emergency physicians should become familiar with the clinical presentations and management of the toxicity ind...
journal_title：Emergency medicine clinics of North America
pub_type： 历史文章,杂志文章
doi：10.1016/s0733-8627(05)70150-4
更新日期：2000-11-01 00:00:00
abstract：:As more Americans venture into the wilderness, physicians will be called upon to provide care in the backcountry or austere setting. Additionally, more isolated regions of the world are becoming accessible for trekking and mountaineering. These facts imply a higher rate of injuries and medical problems within a distin...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章
doi：10.1016/j.emc.2004.01.012
更新日期：2004-05-01 00:00:00
abstract：:Despite recent advances, care of the post-cardiac arrest patient remains a challenge. In this article, the authors discuss an approach to the initial care of post-cardiac arrest patients with particular focus on targeted temperature management (TTM). The article starts with history, physiologic rationale, and the majo...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2019.03.002
更新日期：2019-08-01 00:00:00
abstract：:Health care professionals often encounter patients who refuse a recommended treatment plan. Overriding a patient's right to autonomy has ethical, legal, and moral consequences. Incapacity is the determination by a physician that a patient lacks the ability to make informed decisions about his or her health care. The f...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0733-8627(05)70120-6
更新日期：2000-05-01 00:00:00
abstract：:LSD is still readily available in the United States as a street drug of abuse. Emergency physicians may be called on to diagnose acute LSD intoxication in cases in which the history is unavailable. The typical LSD intoxication syndrome causes marked illusions of color and sound, along with a feeling of "cosmic awarene...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1990-08-01 00:00:00
abstract：:The aging population of the United States creates pharmaceutical challenges for the practicing emergency physician. Polypharmacy, drug-drug and drug-disease interactions, and other pharmaceutical complications from the pathophysiologic changes associated with aging need to be recognized in order to optimize outcomes i...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2016.04.003
更新日期：2016-08-01 00:00:00
abstract：:Stroke should not solely be considered a disease of the elderly, and racial disparities are most evident among young adults. Acute stroke can present at any age and it is important to be familiar with the evaluation and treatment of stroke to provide timely care. The National Institute of Health Stroke Scale helps phy...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2012.05.004
更新日期：2012-08-01 00:00:00
abstract：:Acute urinary retention is a common emergency genitourinary symptom. The etiology of acute retention includes obstructive, neurogenic, pharmacologic, and psychogenic causes. The emergency management of acute urinary retention is bladder decompression, which is usually accomplished with a Foley catheter. ...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1988-08-01 00:00:00
abstract：:The patient with severe head injury is a therapeutic challenge and demands all of the skills of the emergency medical specialist to manage traumatic injuries to the head, chest, abdomen, and limbs, as well as the specialized problems associated with respiratory care in a patient with raised ICP. The initial treatment ...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章
doi：
更新日期：1987-11-01 00:00:00
abstract：:This article is designed to review proper procedure by an emergency or primary care physician when evaluating a patient with decreased hearing. It will cover the anatomy and physiology of hearing, as well as the evaluation and initial management of conductive and sensorineural hearing loss. ...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1987-05-01 00:00:00
abstract：:Acute iron poisoning continues to be one of the most common and deadly poisonings seen by emergency physicians. There are many potential pitfalls in the assessment, diagnosis, and treatment of iron-poisoned patients. This article reviews the pathophysiology of acute iron poisoning and describes a comprehensive managem...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1994-05-01 00:00:00
abstract：:In recent years, health care providers have sounded the call that the US mental health system is in crisis. With decreases in funding and eroding access to care, the availability of psychiatric services has become increasingly limited, failing to meet growing needs. This article provides a brief history of mental heal...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2015.07.013
更新日期：2015-11-01 00:00:00
abstract：:Heat-related illness represents a continuum of disorders from minor syndromes such as heat cramps, heat syncope, and heat exhaustion to the severely life-threatening disorder known as heat stroke. It represents an important cause of wilderness-related morbidity and mortality. ...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2004.01.004
更新日期：2004-05-01 00:00:00
abstract：:Sepsis is recognized by the presence of physiologic and laboratory changes that reflect the inflammatory response to infection on cellular and systemic levels. Comorbid conditions, such as cirrhosis, end-stage renal disease, and obesity, alter patients' susceptibility to infection and their response to it once present...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2016.08.006
更新日期：2017-02-01 00:00:00
abstract：:Epigastric pain is an extremely common complaint in the emergency department and has an associated broad differential diagnosis. In the differential it is important to consider cardiac causes that may be mistaken for gastrointestinal disorders as well as various serious intra-abdominal causes. This article highlights ...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2015.12.012
更新日期：2016-05-01 00:00:00
abstract：:This article reviews out-of-hospital cardiac arrest from a public health perspective. Case definitions are discussed. Incidence, outcome, and fixed and modifiable risk factors for cardiac arrest are described. There is a large variation in survival between communities that is not explained by patient or community fact...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章
doi：10.1016/j.emc.2011.09.003
更新日期：2012-02-01 00:00:00
abstract：:The treatment of gynecologic and other infections in obstetric patients involves consideration of the physiologic changes of pregnancy, the clinical implications of the infection for the patient as well as the fetus, and the safety of antimicrobials available for therapy. This article highlights the treatment of infec...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章
doi：10.1016/j.emc.2012.08.009
更新日期：2012-11-01 00:00:00
abstract：:Pain measurement and relief is complex and should be a priority for prehospital providers and supervisors. The literature continues to prove that we are poor pain relievers, despite the high prevalence of pain in the out-of-hospital patient population. Lack of education and research, along with agent availability, con...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2004.12.009
更新日期：2005-05-01 00:00:00
abstract：:Diseases do not always show the usual or "classic" signs and symptoms in the elderly. Physiologic changes over the years of a long life seem to be responsible for impairment of regulation or function of many organ systems. Since function often is measured in clinical medicine by laboratory testing, physicians frequent...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1990-05-01 00:00:00
abstract：:As the number of advanced practice providers has grown in emergency medicine, establishment of guidelines and policies governing their practice has become increasingly important. This article addresses the scope of practice of physician assistants and nurse practitioners working in the emergency department, including ...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2020.02.007
更新日期：2020-05-01 00:00:00
abstract：:The formulary for dermatologic use in the emergency department must not only encompass drugs that are essential for advanced cardiac and trauma life support, but must have specific drugs that are indicated for common dermatologic conditions that are evaluated in the emergency department. First and foremost is the sele...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1985-11-01 00:00:00
abstract：:Sepsis and septic shock remain all too frequent syndromes in modern medicine with unacceptably high mortality rates. Physicians must be aware of the many ways in which sepsis and septic shock may present and the multiple differential diagnoses. Early recognition and prompt institution of empiric therapy are of utmost ...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1986-11-01 00:00:00
abstract：:This article updates research concerning the resuscitation of a pediatric patient. The topics discussed include the state of pediatric life support, the current guidelines, the management of those guidelines, and coping with death. ...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0733-8627(03)00049-x
更新日期：2002-02-01 00:00:00
abstract：:The endpoints of sedation and analgesia have been more difficult than traditional physiologic parameters to measure adequately. Several clinical scoring systems have been developed in an attempt to provide more consistent and objective assessments of sedation, but the few that have been validated are cumbersome to use...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0733-8627(05)70160-7
更新日期：2000-11-01 00:00:00
abstract：:Acute stroke care is a multidisciplinary effort. It crosses the boundaries of traditional hospital-based medicine, relying heavily on prehospital providers to obtain a significant amount of clinical information. Currently, modifications of existing EMS systems are underway to support the idea that "time is brain." Dis...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0733-8627(02)00011-1
更新日期：2002-08-01 00:00:00
abstract：:Pediatric medical complaints and differential diagnoses often vary from adults, requiring a specialized knowledge base and behavioral skill set. This article addresses a variety of congenital and acquired pediatric genitourinary disorders. Genitourinary emergencies include paraphismosis, priapism, serious infection, s...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2011.04.003
更新日期：2011-08-01 00:00:00
abstract：:Respiratory failure is a frequent disease process encountered in the emergency department. There is significant need for improvement in the care of patients on mechanical ventilation. If not contraindicated, lung-protective ventilation strategies should be used. It is important to consider pathophysiology (shunting, d...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2014.07.012
更新日期：2014-11-01 00:00:00
abstract：:Injury to the chest accounts directly or indirectly for up to 50 per cent of deaths secondary to trauma. Eighty-five per cent of patients with chest injury may be managed by minor procedures available to the emergency physician. The indications for surgery in the remaining 15 per cent of patients with chest injury mus...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章
doi：
更新日期：1984-11-01 00:00:00
