Emergency Medicine

216 Environmental Emergencies Further Reading MANAGEMENT 1 Use standard protocols for VF and asystolic cardiac arrest if there i ...

SURGICAL EMERGENCIES Section VIII ...

218 Surgical Emergencies MULTIPLE INJURIES OVERVIEW The management of every severely injured patient requires a coordinated appr ...

MULTIPLE INJURIES Surgical Emergencies 219 7 The time-honoured mnemonic for the initial sequence of care is ABCDE (see Table 8.1 ...

MULTIPLE INJURIES 220 Surgical Emergencies 2 Maintain the integrity of the cervical spine (i) Place the unconscious head injury ...

MULTIPLE INJURIES Surgical Emergencies 221 (iv) Infusion fluid (a) infuse normal saline or Hartmann’s (compound sodium lactate) ...

MULTIPLE INJURIES 222 Surgical Emergencies (a) lateral cervical spine X-rays have now largely been replaced by incorporating the ...

Head and Facial Injuries Surgical Emergencies 223 Make sure an ongoing record is kept of all vital signs and clinical findings, ...

Neck Injuries 224 Surgical Emergencies 4 Nose (i) Examine for evidence of blood or cerebrospinal fluid (CSF) leakage suggesting ...

NECK INJURIES Surgical Emergencies 225 3 Palpate for areas of tenderness, swelling or deformity in the neck. Assess for limb ton ...

NECK INJURIES 226 Surgical Emergencies (a) use reinforcement (Jendrassik’s manoeuvre) before concluding that a reflex is absent, ...

NECK INJURIES Surgical Emergencies 227 the retrotracheal space should be less than the width of one vertebral body in adults be ...

NECK INJURIES 228 Surgical Emergencies (v) MRI is more sensitive than CT and plain X-ray for identifying soft-tissue damage such ...

NECK INJURIES Surgical Emergencies 229 (ii) Infuse methylprednisolone 30 mg/kg over 15 min, followed 45 min later by 5.4 mg/kg p ...

NECK INJURIES 230 Surgical Emergencies (iv) Hypoglossal nerve: deviation of the tongue to the affected side. (v) Cervical sympat ...

Surgical Emergencies 231 Chest Injuries Pneumothorax DIAGNOSIS 1 Tension pneumothorax (i) This causes severe respiratory distres ...

CHEST INJURIES 232 Surgical Emergencies 4 Look for diffuse ground-glass haziness over one hemithorax if the CXR is taken supine, ...

CHEST INJURIES Surgical Emergencies 233 3 Refer the following patients to the surgical team for admission: (i) Pneumothorax, hae ...

CHEST INJURIES 234 Surgical Emergencies 5 Request a CXR. 6 Organize an echocardiogram, which may show wall motion abnormalities ...

CHEST INJURIES Surgical Emergencies 235 (b) other causes of a widened mediastinum include a mediastinal haematoma from sternal f ...