' Emergency Medicine '

Op. Dr. Ali GÜRTUNA On 21 Mar, 2012 At 10:41 AM | Kategori: Emergency Medicine

Spinal Cord Injury Urinary Tract Infection A urinary tract infection should be suspected when a spinal-cord-injured patient presents with fever, discomfort over the kidney or bladder, worsening spasticity, development of urinary incontinence, autonomic dysreflexia, cloudy or foul-smelling urine, a change in energy level, or a feeling of apprehension. Unless there are confounding factors, the urinalysis […]

Op. Dr. Ali GÜRTUNA On 21 Mar, 2012 At 10:27 AM | Kategori: Emergency Medicine

Rural Emergency Medical Services Most EMS literature has been developed by urban and suburban systems, with little emphasis on rural EMS care. The rural environment provides a number of unique challenges to providers of emergency care. Long distances over which to reach and transport patients are the central issue. Specialized search and rescue capabilities may […]

Op. Dr. Ali GÜRTUNA On 21 Mar, 2012 At 10:52 AM | Kategori: Emergency Medicine

Venous Access in morbidly obese patient Morbidly obese patients are notoriously difficult candidates for intravenous catheterization, venipuncture, or arterial puncture. Anatomy is distorted by subcutaneous fat, and landmark vessels are often not visible or palpable. This leads to multiple attempts, delay in access, and an increased incidence of central line placement, with delays in changing […]

Op. Dr. Ali GÜRTUNA On 21 Mar, 2012 At 10:44 AM | Kategori: Emergency Medicine

Trauma in morbidly obese patient Differences in the mechanisms of injury and associated injury patterns have been described, and obesity has been identified as an independent premorbid risk factor in trauma. Excessive weight interferes with activities of daily living, therefore increasing the risk of injury. Moreover, the presence of obesity-related diseases such as diabetes, heart […]

Op. Dr. Ali GÜRTUNA On 21 Mar, 2012 At 10:28 AM | Kategori: Emergency Medicine

Diagnostic Peritoneal Lavage in morbidly obese patient Diagnostic peritoneal lavage (DPL) is used for the early recognition of intraabdominal injury requiring exploratory laparotomy. In many centers, the use of DPL has been supplanted by imaging techniques because of increased accessibility to improved computed tomography (CT) and ultrasonography. However, size and weight restrictions and transport difficulties […]

Op. Dr. Ali GÜRTUNA On 21 Mar, 2012 At 10:15 AM | Kategori: Emergency Medicine

Cardiopulmonary Disease in morbidly obese patient Morbidity and mortality are considerably greater among the obese than in normal-weight patients, and many of the health risks associated with obesity increase progressively and disproportionately with increasing weight. The most significant physiologic disturbances pertain to the cardiopulmonary system. Coronary artery disease, hypertension, and congestive heart failure are highly […]

Op. Dr. Ali GÜRTUNA On 21 Mar, 2012 At 10:15 AM | Kategori: Emergency Medicine

Airway Management in morbidly obese patient Obesity may be associated with difficult intubation or bag-valve-mask ventilation, particularly if other predictors of intubation difficulty are present. Obesity alone is not a contraindication to rapid-sequence intubation and this may be the preferred method in most patients. However, in this population it is particularly important to assess and […]

Op. Dr. Ali GÜRTUNA On 21 Mar, 2012 At 10:08 AM | Kategori: Emergency Medicine

The Morbidly Obese Patient Obesity is the condition of an excessive proportion of adipose tissue to total body weight. It is a major health problem, with the prevalence of obesity in the United States doubling in the past 20 years, such that today over half of all adults are estimated to be overweight. Since body […]

Op. Dr. Ali GÜRTUNA On 21 Mar, 2012 At 10:03 AM | Kategori: Emergency Medicine

Vascular Infections in injection drug users Vascular injury associated with IDU includes inadvertent arterial injection with resultant vasospasm or thrombosis, septic thrombophlebitis, venous and arterial pseudoaneurysms, and infected hematomas. Arterial injection rarely results in major vessel occlusion; instead, pain, edema, and patchy mottling of the affected limb caused by ischemia occur. Tissue necrosis and gangrene […]

Op. Dr. Ali GÜRTUNA On 21 Mar, 2012 At 10:03 AM | Kategori: Emergency Medicine

Skin and Soft Tissue Infections in injection drug users Unique features of skin infections in the injection drug user include a high rate of skin and pharyngeal colonization with S. aureus and streptococcal species, and the high frequency with which cutaneous abscesses are caused by oral flora. Conflicting evidence exists as to whether HIV seropositivity […]

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