Background Since the inception of the practice of medicine, there have been ethical challenges for doctors and other health care professionals. Many of the challenges, such as who has the authority to make key decisions (autonomy vs. paternalism) and what…
Introduction Two truisms of economics are that the supply of goods and services is finite and that supply is never sufficient to meet all demands. The tension between supply and demand for food, water, energy, education, and other goods and…
Nearly a quarter of the deaths in the United States occur in the intensive care unit (ICU), and the majority of patients who die in the ICU have had life-sustaining measures limited or withdrawn. , A decision to withhold or…
Historical perspective The increasing gap between the number of organs available for transplantation and the number of patients listed for transplantation has become a rate-limiting step in reducing both wait times and wait list deaths in patients awaiting transplantation. Before…
Introduction The diagnosis of death using neurologic criteria is recognized as the complete and irreversible loss of capacity for consciousness and all brain function as a consequence of catastrophic brain injury. Historically and in many countries, this diagnosis is called…
Introduction Pelvic and long bone fractures are found frequently in trauma patients, especially in blunt polytrauma patients with significant injury burden. Initial intensive care management of severe pelvic fractures or long bone injury is similar: damage control resuscitation, hemorrhage control,…
Introduction Trauma is the leading cause of death in patients between 1 and 44 years of age. The trauma patient requires rapid and systematic evaluation by a multidisciplinary team using principles defined by Advanced Trauma Life Support (ATLS). These principles…
Thoracic trauma is responsible for approximately 20% of all trauma-related deaths and is second only to central nervous system injury as the primary cause of death at the scene. For patients arriving at the emergency department (ED) alive, rapid diagnosis…
Introduction Patients with severe burns today are more likely to survive compared with those injured decades ago. Advances in early source control of deep burns, antimicrobial strategies, and critical care medicine are largely responsible, buoyed by translational research in burn-induced…
Epidemiology A pressure ulcer is any wound that develops in the upper, outer layers of the skin as a result of sustained, external pressure. Pressure ulcers are serious complications among hospitalized patients. They increase healthcare costs, decrease patient quality of…