Key Concepts The accuracy of a physical examination is limited in cases of abdominal trauma. It is rendered less reliable by distracting injury, altered sensorium (e.g., head trauma, alcohol or drug intoxication, developmental delay, psychiatric illness), and spinal cord injury.…
Key Concepts Even relatively minor chest wall injuries, such as rib fractures, may result in serious complications in elderly patients and patients with preexisting pulmonary disease if adequate analgesia and close follow-up care are not provided. Unless there are abnormalities…
Key Concepts Significant injuries to the cerebral vessels can occur as a result of blunt or penetrating trauma to the neck. Blunt trauma to the neck can lead to immediate or delayed ischemic strokes, and a low threshold for imaging…
Key Concepts NEXUS or CCR decision rules may be used to determine the need for radiographic imaging in the awake, evaluable trauma patient. CT scanning is preferred over plain radiography in the evaluation of the trauma patient with potential spinal…
Key Concepts The face is central to the patient’s ability to breathe, eat, and communicate. Injuries to the face can have serious psychological and psychosocial consequences. Facial injuries may be prevented by the appropriate use of safety devices including motor…
Key Concepts Head trauma is a broad term describing an external trauma to the craniofacial area of the body from blunt, penetrating, blast, rotational, or acceleration-deceleration forces. The term head injury refers to a clinically evident injury on physical examination,…
Key Concepts Immediately after a trauma patient arrives the emergency department (ED), the primary survey should be performed in a standardized fashion. The goal of the primary survey is to rapidly identify and initiate the treatment of critical, and life-threatening…
Acknowledgments The authors would like to thank Roy Hatch for his invaluable assistance in preparing this chapter. Key Concepts Acute low back pain is a common, costly, recurring and painful condition that often has no recognizable or dangerous cause. While…
Key Concepts Pregnancy status is the single most important determination to make in evaluating a patient with vaginal bleeding. The use of the term dysfunctional uterine bleeding is no longer recommended, and the term abnormal uterine bleeding is preferred. The…
Key Concepts Acute pelvic pain in women is often from a gynecologic source, but urinary and intra-abdominal sources are also common. Less frequently, the pain may arise from vascular, musculoskeletal, neurologic, or psychiatric disorders. Potentially lethal diagnoses associated with acute…