Emergency medicine clinics of North America
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Pharmacologic agents are used to improve conditions that may contribute to the development of cardiac arrest such as dysrhythmias, hypotension, shock, or anoxia. The authors review the clinical application of several specific agents in resuscitation.
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Emerg. Med. Clin. North Am. · Dec 1983
ReviewAcute resuscitation of the patient with head and spinal cord injuries.
The major immediate goal in the treatment of a patient with central nervous system injuries is to prevent secondary injuries resulting from hypotension, hypoxemia, hypercapnia, intracranial hypertension, infection, and unnecessary motion of an unstable spinal column. This combined with application of the fundamentals of trauma resuscitation should achieve optimal results.
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Every pediatric patient should be resuscitated unless there is rigidity, body decay, known terminal illness, or irreparable damage. The techniques for pediatric CPR are described in detail.
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Submersion accidents are an important public health problem in this country and worldwide, and they present a special challenge to emergency personnel. Submersion injury affects multiple systems but most notably involves the lungs, where ventilation-perfusion mismatching and intrapulmonary shunting result in hypoxemia, acidosis, and generalized anoxic injury. Resuscitation of the victims of submersion casualties should be directed at restoring respiration, improving oxygenation, correcting acidosis, and treating concomitant problems such as hypothermia, drug and alcohol intoxication, or cervical spinal trauma. With expeditious and proper treatment, most submersion victims have a good prognosis.
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The health problems of diving are due primarily to the breathing of compressed air or other gas mixtures at higher than normal atmospheric pressure. This article focuses on the three main pressure-related syndromes that are collectively known as dysbarism. Emergency physicians should be familiar with the special considerations required in the management of victims of diving casualties.