Seminars in thoracic and cardiovascular surgery
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Semin. Thorac. Cardiovasc. Surg. · Jul 1992
ReviewThe multi-injured patient: the Maryland shock trauma protocol approach.
Thoracic trauma will continue to be a major cause of morbidity and mortality in our population. Improvement in ambulance transport systems and prehospital care has improved the salvage rate. It is hoped that earlier recognition, better understanding of the pathophysiology, and improvement in management will further reduce the number of deaths due to thoracic injuries.
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Semin. Thorac. Cardiovasc. Surg. · Jul 1992
ReviewBlunt cardiac trauma: clinical manifestations and management.
In conclusion, blunt cardiac trauma is the leading cause of fatalities following motor vehicle accidents. Although many of the patients with anatomic cardiac injuries die at the scene, with improved prehospital care these patients have more likelihood of surviving the first hour and presenting to an emergency room alive for definitive treatment. Prompt recognition of the injury based on the mechanism and a high index of suspicion must lead to immediate surgical intervention in order for these patients to survive. ⋯ This will allow better allocation of scarce hospital resources rather than blindly pursuing "routine" (expensive) work-ups. The sequelae of these injuries are generally nonfatal. If serious sequelae do arise in the ICU or in the OR, prompt treatment with inotropic support is usually successful.