Essentials 1 Initial management priorities are oxygenation, ventilatory support if required, pleural and pericardial decompression when indicated, circulatory support, adequate analgesia and early imaging to identify evolving and potentially life-threatening injuries. 2 Less than 10% of blunt chest trauma patients…
Essentials 1 One in 10 deaths from trauma is due to abdominal injuries. 2 Abdominal injuries may be occult—overshadowed by more apparent external and orthopaedic injuries—and may be missed initially. 3 Detection of intra-abdominal injuries requires a high index of…
Essentials 1 Facial trauma occurs as isolated injury with assault, sporting mishaps, falls and as part of complex multisystem injury. 2 Immediate threat to life may relate to airway obstruction or local haemorrhage; however, threat to life is mostly due…
Essentials 1 Clinically significant cervical spine injury can be confidently eliminated in conscious, clear-headed patients below 65 years of age using clinical examination criteria (as described in National Emergency X-Radiography Utilization Study (NEXUS) and Canadian C-spine rules) alone. 2 Physical…
Essentials 1 Neurotrauma is the most common cause of death in trauma. 2 A detailed history of the mechanics of the trauma experienced is invaluable. 3 Secondary brain injury is a major and potentially preventable cause of mortality and long-term…
Essentials 1 Injuries cause 9% of all deaths. 2 Trauma remains the leading cause of death in those aged from 1 to 44 years in the most highly developed countries. The burden of injury is especially high in developing countries.…
Essentials 1 The term anaphylaxis describes both immunoglobulin E (IgE) immune–mediated reactions and non-allergic, non-immunologically triggered events. Co-morbidities—such as asthma, infection, exercise, alcohol and stress or concurrent medications such as β-blockers, angiotensin converting enzyme inhibitors and aspirin—increase the risk (‘summation…
Essentials 1 Neurological injury is common following out-of-hospital cardiac arrest and carries a high rate of morbidity and mortality. 2 Successful resuscitation leads to reperfusion of an ischaemic brain, and this may result in biochemical cascades, largely mediated by calcium…
Essentials 1 The value of arterial blood gas analysis is dependent on understanding and correctly interpreting the results in the clinical context. 2 When abnormalities are detected with arterial blood gas analysis, make sure that the sample was obtained, transported…
Essentials 1 Early recognition and intervention in the emergency department reduces mortality in patients with sepsis and septic shock. 2 Appropriate broad-spectrum antibiotics should be administered within 1 hour of the recognition of sepsis. 3 Systemic blood pressure, serum lactate…