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Section 2 - Trauma

Published online by Cambridge University Press:  05 November 2013

Kaushal Shah
Affiliation:
Department of Emergency Medicine, Mount Sinai School of Medicine, New York
Jarone Lee
Affiliation:
Department of Emergency Medicine, Massachusetts General Hospital, Boston
Kamal Medlej
Affiliation:
American University of Beirut
Scott D. Weingart
Affiliation:
Department of Emergency Medicine, Mount Sinai School of Medicine, New York
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Summary

This chapter discusses the management of trauma. The primary survey for a trauma patient is performed with regard to airway, breathing and circulation. Several airway adjuncts are available to assist in endotracheal intubation, including the gum elastic bougie, supraglottic airway devices, videolaryngoscopy, or fiberoptic scopes. The breathing evaluation include visualization of chest rise, auscultation of breath sounds, palpation of the chest wall feeling for crepitus or flail segments, and assuring that the trachea is midline. The patient is examined for signs of hemorrhage, including all compartments that can hold life-threatening amounts of blood loss. Evaluation for disability in the primary survey should include Glasgow Coma Scale (GCS), neurological examination to rule out neurological deficit, and pupil examination for signs of intracranial injury. Emergency department thoracotomy (EDT) is a resuscitative procedure that has low survival rate and should be performed in unique circumstances.
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Publisher: Cambridge University Press
Print publication year: 2013

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