Canadian journal of surgery. Journal canadien de chirurgie
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Small-volume resuscitation with hypertonic saline is an attractive modality but is still at an early stage of experimental and clinical investigation. Aggressive resuscitation from traumatic, hypovolemic shock could be facilitated during the prehospital phase, but hypotension remains a physiological and beneficial compensatory mechanism to minimize active bleeding until definitive care is provided. Despite encouraging results, the author concludes that, at present, hypertonic saline cannot be considered a truly "magic potion" for resuscitation of the trauma patient.
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Emergency airway management in the patient with blunt trauma is a clinical dilemma. Many of these patients require immediate airway management, but each method carries its own set of risks and benefits. ⋯ In this article, the issues surrounding selection of an appropriate technique for airway management are reviewed critically. Recommendations are made for management of the airway in this high-risk group of patients with injury to the cervical spine.