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8 results

  • Chapter 15 - Traumatic Brain Injury

  • from Section 3 - Specific Neurological Disorders in Emergency Medicine
  • Edited by Thomas P. Campbell, Allegheny Health Network, Pittsburgh, Kevin M. Kelly, Allegheny Health Network, Pittsburgh
  • Book:
    Handbook of Emergency Neurology
    Published online:
    10 January 2024
    Print publication:
    17 August 2023, pp 227-234

  • Summary

    Traumatic brain injury (TBI) is an increasingly common cause of morbidity and mortality in the United States. Rates of emergency department visits for TBI rose 70% between 2001 and 2010, with an estimated 2.5 million patients/year seeking emergency care, highlighting the increased focus on early identification and treatment of brain injuries. Hospital admission rates for TBI rose 11% in this time frame while deaths decreased 7%. Despite improvements in the management of TBI, 50,000 people die each year from this trauma (30% of all trauma related deaths in the United States). Falls are the most common mechanism of TBI, followed by blunt trauma, motor vehicle collisions, and assault. Men are three times more likely to sustain a TBI than their female counterparts, whereas the very young (<4 years old) and older patients (>65 years old) are more likely to sustain head trauma than those of other ages.

  • Chapter 9 - Procedures for orthopedic emergencies

  • Edited by Michael C. Bond
  • Edited in association with Andrew D. Perron, Michael K. Abraham
  • Book:
    Orthopedic Emergencies
    Published online:
    05 November 2013
    Print publication:
    31 October 2013, pp 191-247

  • Summary

    This chapter presents the key facts, clinical presentation, diagnostic testing, treatment of procedures, and prognosis of shoulder and elbow emergencies such as glenohumeral dislocations, scapular fractures, clavicle fractures, sternoclavicular (SC) injuries, acromioclavicular injuries, and proximal humerus fractures. Failure to obtain a lateral projection can result in missing a posterior dislocation in up to 50% of cases. Reductions performed with intra-articular anesthetic injections have been safely performed with equivalent success rates, similar patient comfort, shorter ED length of stays, and lower complication rates. Electromyogram (EMG) testing can be performed at a later date to evaluate suspected nerve injuries. Presence of a posterior SC dislocation should prompt evaluation for associated injuries to the trachea, esophagus, and great vessels, which are in close proximity to the SC joint. Plain radiographs are the preferred test for evaluation of suspected humeral shaft fractures.

  • 7 - Care of victims of torture

  • Fiona E. Gallahue, Laura D. Melville
  • Book:
    Emergency Care of the Abused
    Published online:
    17 August 2009
    Print publication:
    14 July 2008, pp 192-232

  • Summary

    1. To learn what types of torture exist and screen patients who are potential survivors of torture

    2. To understand the acute and chronic effects of torture on patients

    3. To learn how to treat, document, and refer survivors of torture

    ‘Medicine and torture both hold a topographical affinity for each other in the sense that both reside and ‘colonise’ the private space of the sentient body of a human being: one to save a life and the other to destroy it.’

    – Merlau-Ponty (Vinar, 2005)

    The recent atrocities at Abu Ghraib have once again focused attention on victims of torture. Photographs from this prison site vividly illustrate the immediate physical damage sustained by victims of torture; however, these pictures do not fully illustrate the extensive long-term medical and psychological injuries sustained by these individuals. Furthermore, most victims of torture do not present in such a dramatic fashion. The United Nations (UN) High Commission of Refugees estimates that worldwide there were 9.7 million victims of torture in 2004 and Amnesty International estimates that 104 countries still practice some form of torture today. As victims of torture often flee their homeland after the abuse, physicians worldwide should be familiar with the medical needs of torture victims. This chapter will familiarize physicians with the current definitions of torture and types of torture used today as well as common medical and psychological concerns of these individuals.