Journal of trauma nursing : the official journal of the Society of Trauma Nurses
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Propofol (Diprivan) is an intravenous sedative hypnotic that is used in the induction and maintenance of anesthesia and sedation. High-dose infusions have been associated with several serious adverse effects and, when combined, they are known as propofol infusion syndrome (PRIS). Although PRIS is rare, it is frequently fatal if not identified early. The purpose of this article is to raise practitioner awareness to this syndrome, with recommendations for early identification, prevention, and treatment of PRIS.
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Trauma is responsible for 25% of all emergency department visits causing a healthcare burden of more than $400 billion a year. Timely and appropriate fluid resuscitation may mean the difference between survival and death. ⋯ This article will evaluate current research regarding the various types of fluid resuscitation in the trauma population. Colloid and crystalloid fluid will be compared describing the risks and benefits of each.
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Emergency department visits reached more than 115 million in 2005, a 30% increase over the past decade. Although much has been written regarding these numbers, little attention has been focused on the impact of overcrowding and volume increases on rural emergency departments. Rural emergency departments face challenges unlike their urban counterparts that make implementation of current overcrowding strategies difficult or impossible. This article addresses these challenges and suggests strategies specific to the needs of rural emergency departments.
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The human core temperature is maintained by highly controlled regulatory mechanisms that balance heat production and heat loss. When this balance is interrupted, there are consequences for human physiology that are not yet fully understood. ⋯ In some instances, such as cardiac arrest, traumatic brain injury, and organ transplantation, controlled hypothermia can be physiologically beneficial, but hypothermia in traumatic injury is distinctly different. In trauma, hypothermia often begins at the time of injury as a result of increased heat loss by conduction and convection due to exposure and reduced heat production due to decreased motor activity.
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Truma surgery today is facing a number of significant challenges that offer a stimulus for growth and evolution of tl practice. To successfully face these challenges, reexamination of the discipline, the current practice models for its providers, and the definition/scope of the specialty will be necessary. Further development and application of the cute care surgery model may represent the future direction for trauma care practitioners.