Beruflich Dokumente
Kultur Dokumente
Join Scribd to gain access to this document and millions of other titles,
including books, audiobooks, comics, and more.
Pick the plan that s right for you:
One-day Unlimited Access
$8.9924 hours
24 hours of access.
Billed at time of purchase.
Monthly Membership
Our most popular option
$8.99per month
Billed once a month.
Cancel anytime.
Annual Membership
$3.99per month
Billed once a year.
Cancel anytime.
JOIN AND DOWNLOAD NOW
As seen on
Logo_nytLogo_wsjLogo_guardianLogo_timeLogo_cnn
Want free access?
Upload a high-quality, legitimate document to the Scribd library, and gain acces
s to this document, free!
Start Uploading
s
Search
UPLOADLIBRARY
BooksAudiobooks
DOWNLOADSTANDARD VIEWFULL VIEW
27
OF 172
1
!Emergeortho procedures
Ratings: (0)|Views: 107|Likes: 0
Published by Georgios Mandelas
about ortho procedures
See more
You're reading a free preview.
Pages 4 to 29 are not shown in this preview.
READ THE FULL VERSION
You're Reading a Free Preview
Page 4 is not shown in this preview.
DOWNLOAD
You're Reading a Free Preview
Page 5 is not shown in this preview.
DOWNLOAD
You're Reading a Free Preview
Page 6 is not shown in this preview.
DOWNLOAD
You're Reading a Free Preview
Page 7 is not shown in this preview.
DOWNLOAD
You're Reading a Free Preview
Page 8 is not shown in this preview.
DOWNLOAD
You're Reading a Free Preview
Page 9 is not shown in this preview.
DOWNLOAD
You're Reading a Free Preview
Page 10 is not shown in this preview.
DOWNLOAD
You're Reading a Free Preview
Page 11 is not shown in this preview.
DOWNLOAD
You're Reading a Free Preview
Page 12 is not shown in this preview.
DOWNLOAD
You're Reading a Free Preview
Page 13 is not shown in this preview.
DOWNLOAD
You're Reading a Free Preview
Page 14 is not shown in this preview.
DOWNLOAD
You're Reading a Free Preview
Page 15 is not shown in this preview.
DOWNLOAD
You're Reading a Free Preview
Page 16 is not shown in this preview.
DOWNLOAD
You're Reading a Free Preview
Page 17 is not shown in this preview.
DOWNLOAD
You're Reading a Free Preview
Page 24 is not shown in this preview.
DOWNLOAD
8Emergency Room Orthopaedic Procedures
St
ep 5: Wrist Block-Radial Nerve
Pronate the hand and place it on a sterile drape.
Insert the needle 2 cm proxima
l to the tip of the radial styloid along the radial aspect of the distal forearm
(Fig. 1.6). Inject 7 to
10 cc of anesthetic along the radial and dorsal aspect of the wrist and distal f
orearm, between the ?rst and third dorsal compart-ments (the tendons of the abdu
ctor pollicis longus, and extensor pollicis brevis and the extensor pollicis lon
gus).
SUGGESTED READINGS
1. Chale S, Singer AJ, Marchini S, et al. Digital versus local anesthesia for ?n
ger lacerations: A randomized controlled trial. Academic Emergency
Medicine. 2006;13(10):1046-50.
2. Chiu D?. ?ransthecal digital block: Flexor tendon sheath used for anesthetic infusion. J Hand Surg Am. 1990;15(3):471-3.4.
3. Egol Kenneth A, Kenneth J Koval, Joseph D Zuckerman. Handbook of
Fractures, 4th edn. Philadelphia, PA: Lippincott Williams & Wilkins; 2010. pp. 6
8-9.
Fig. 1.6 Super?cial radial nerve block performed by injecting local anes
thetic 2 cm proximal to the tip of the radial styloid along the radial aspect
of the distal forearm
You're Reading a Free Preview
Page 25 is not shown in this preview.
DOWNLOAD
Nerve Blocks Around the Hand9
4. Setnik and Tomson Associates. Local anesthesia techniques [online]. Te Multim
edia Procedure Manual. Available from http://emproce-dures.com/anesthesia/pharma
cology.htm5. Whetzel ?P, Mabourakh S, Barkhordar R. Modi?ed transthecal digital
block. J Hand Surg Am. 1997;22(2):361-3. 6. Yin ZG, Zhang JB, Kan SL, et al. A c
omparison of traditional digital
blocks and single subcutaneous palmar injection blocks at the base of the ?nger
and a meta-analysis of the digital block trials. Journal of Hand
Surgery (British and European Volume). 2006;31(5):547-55.
You're Reading a Free Preview
Page 26 is not shown in this preview.
DOWNLOAD
INTRODUCTION
Ankle fractures, commonly present to the emergency department, following injuri
es sustained during athletic participation or from higher energy traumatic event
s. Tey account for 12 percent of all bony injuries and often are the result of a
rotational mechanism. Important factors in?uencing the type of ankle fracture s
ustained include the patient s age, bone quality, position of the foot at the time
of injury, and the magnitude, direction and rate of the force applied. Te follo
wing chapter will review the relevant anatomy, methods of evaluation, classi?cat
ion and techniques for both frac-ture reduction and splinting.
RELEVANT ANATOMY
?he ankle is a hinge or saddle-type joint, composed of the distal tibia, the dis
tal fibula and the dome of the talus. ?he articular surface of the distal tibia
(the plafond) combined with the medial and lateral malleoli form the ankle morti
se, which is a constrained articulation for the talar dome. ?he dome of the talu
s is approxi-mately 2.5 mm wider anteriorly than it is posteriorly, helping prov
ide ankle stability in the dorsiflexed position during weight-bearing activities
.
Eric J Strauss
The Evaluation and Management of Ankle Fractures: Reduction and Splinting Techni
ques
2
You're Reading a Free Preview
Page 27 is not shown in this preview.
DOWNLOAD
The Evaluation and Management of Ankle Fractures11
Te ankle is supported by a system of ligamentous structures including the anteri
or talo?bular ligament (A?FL), posterior talo?b-ular ligament (P?FL) and calcane
o?bular ligament (CFL) laterally, and the deltoid ligament complex medially (com
posed of a super?-cial portion and a deep intra-articular portion). Additional s
upport is provided by the syndesmotic ligament complex, which provides resistanc
e to rotational, axial and translational forces by connecting the distal tibia a
nd ?bula (Fig. 2.1). Te syndesmosis is comprised of the anterior inferior tibio?
bular ligament (AI?FL), the posterior inferior tibio?bular ligament (PI?FL), the
transverse tibio?bular ligament and the interosseous ligament which is a distal
extension of the syndesmotic membrane. Functionally, ankle motion occurs in dor
si?exion and plantar ?exion, with 30 of dorsi?exion and 45 of plantar ?exion, is c
onsid-ered normal. Inversion and eversion of the ankle takes place at the level
of the subtalar joint, formed at the articulation of the talus and the calcaneus
. Secondary to the strength of the ligamentous struc-tures supporting the subtal
ar joint, inversion and eversion forces tend to cause injury to the structural c
omponents of the ankle joint.
Fig. 2.1
Te ankle joint is stabilized by its supporting ligaments in-cluding the anterior
talo?bular ligament (A?FL), posterior talo?bular ligament (P?FL) and calcaneo?b
ular ligament (CFL) laterally and the deltoid ligament complex medially.
You're Reading a Free Preview
Page 28 is not shown in this preview.
DOWNLOAD
12Emergency Room Orthopaedic Procedures
PRESENTATION AND EVALUATION IN THE EMERGENCY ROOM
Patients with ankle fractures typically present to the ER with complaints of pai
n, swelling and di?culty with weightbearing activ-ities following a rotational t
ype mechanism of injury (Fig. 2.2). Tey may have gross deformity present which s
hould alert the evaluating physician to the possibility of a fracture dislocatio
n. Some patients may be capable of weightbearing with discomfort despite the pre
s-ence of bony injury while others may be unable to bear any weight at all on th
e injured lower extremity.Te initial evaluation includes an inspection of the in
jured ankle, noting the presence of deformity and the condition of the surroundi
ng soft tissue, looking for evidence of an open injury or the presence of bliste
ring. A careful neurovascular examination should be performed and documented in
the patient s chart. Next, the entire length of the ?bula should be palpated for
tenderness and the presence of a bony step-o?, indicative of a displaced fractur
e. Palpation of the ankle should
Fig. 2.2
Patient who presented to the emergency room with a left ankle fracture. Note the
ecchymosis and swelling present about the lateral aspect of the ankle in the re
gion of the lateral malleolus
You're Reading a Free Preview
Page 29 is not shown in this preview.
DOWNLOAD
The Evaluation and Management of Ankle Fractures13
be continued medially, looking for tenderness over the medial malle-olus and the
deltoid ligament complex. A squeeze test can then be performed by squeezing 5 cm
proximal to the intermalleolar line to identify a possible injury to the syndesm
osis.
RADIOGRAPHIC EVALUATION
A three-view series of the ankle is typically utilized for the diagnosis of ank
le fractures in the ER. Tis series is composed of an anteroposte-rior (AP) view,
a lateral view and a mortise view (Figs 2.3A-C).
Figs 2.3A-C An ankle trauma X-ray series of the right ankle showing evidence of
displaced bimalleolar ankle fracture (A) Anteroposterior; (B) Mortise; (C) Later
al
A BC
You're reading a free preview.
Pages 33 to 69 are not shown in this preview.
READ THE FULL VERSION
You're reading a free preview.
Pages 73 to 81 are not shown in this preview.
READ THE FULL VERSION
You're reading a free preview.
Pages 85 to 162 are not shown in this preview.
READ THE FULL VERSION
You're reading a free preview.
Pages 166 to 172 are not shown in this preview.
READ THE FULL VERSION
Activity (1)
FILTERSAdd to collectionReviewAdd NoteLike
1 hundred reads
Similar to !Emergeortho procedures
Practical Procedures in Orthopaedic Trauma Surgery
Master Techniques in Orthopaedic Surgery Soft Tissue Surgery
Master Techniques in Orthopaedic Surgery
Office Orthopaedics
Master Techniques in Orthopaedic Surgery - Relevant Surgical Exposures
Surgical Exposures in Orthopaedics the Anatomic Approach, 4th 2009 Pg
Operative Orthopaedics Stanmore Guide 2010
Key Topics in Orthopaedic Trauma Surgury
Adam's Outline of Orthopaedics 14th Edition
Tendon Transfers
Rockwood and Green's Fractures in Adults, 7th Edition 2010 Azmy2000
Book.splint.cast(Ghips)
Atlas of Emergency Trauma
Fractures of the Upper Extremity
Pearls and Pitfalls in Musculoskeletal Imaging (2013) [PDF] [UnitedVRG]
28meu.master.techniques.in.Orthopaedic.surgery.sports.medicine
Atlas of Pain Injection Techniques, 2e.pdf
SOAP for Orthopedics [PDF][Tahir99] VRG
Current Diagnosis and Treatment Critical Care, 3rd edition.pdf
Case Files Orthopaedic Surgery
Fractures of Shoulder Girdle
Photografic manual of regional orthopaedic and neurological .pdf
FRCS Trauma and Orthopaedics Viva (2012).pdf
Atlas of Minimally Invasive Hand and Wrist Surgery
Netter's Orthopaedics
0470391642
Minimally Invasive Spine Surgery (Minimally Invasive Procedures in Orthopaedic S
urgery)
Atlas of Orthopedic Examination of the Peripheral Joints
ECG Rounds (McGraw-Hill)
The A to Z of Bones, Joints and Ligaments and the Back
More From This User
Hallux Valgus Osteotomies
2012-1919 DTS Brochure 7024 RevF r2 Old
!Emergency.room.Orthopaedic.procedures.an.Illustrative.guide.for.the.house.offic
er
Dangerous Dogs
10 Pragmata Anti Kafe
The Outcomes of Hip Resurfacing Compared to Standard Primary Total Hip Arthropla
sty in Men
12 de Smet Van Ransbeeck
Become Rich Migrating
islandia giati petyxe
frouta kalokairiou
17 Body Tricks
Greek Summer
Eksetaseis Gia Andres
An Spasei to Prfylaktiko
50 Movies to Have
Pas Mi Ellin Varvaros
Leisureguy s Guide to Gourmet Shaving Ham Michael
TKA Patient-Specific Instruments Level 2 Evidence
17 Body Tricks
50 Movies to Have
Groin Pain
Chronic Pelvic Pain
Developmental Dysplasia of the Hip
Lower Limb Fractures
Download and print this document
Read and print without ads
Download to keep your version
Edit, email or read offline
Choose a format:
.PDF.TXT
DOWNLOAD
Recommended
Practical Procedures in Orthopaedic Trauma Surgery
Andrei Rusu
ortopedie
Master Techniques in Orthopaedic Surgery Soft Tissue Surgery
Abotaleb Mohd
Master Techniques in Orthopaedic Surgery
sasa0687
Master Techniques in Orthopaedic Surgery
Office Orthopaedics
John Reynolds
Orthopaedic
Previous|NextPage 1 of 8
Download and print this document
Read and print without ads
Download to keep your version
Edit, email or read offline
Choose a format:
.PDF.TXT
DOWNLOAD
ABOUT
Browse books
Browse documents
About Scribd
PCS S
CIENTIFIC
P
UBLICATION
N
O
. 12
Foreword
2nd Edition . . .
Cenon R. Alfonso
, MD, FPCS, ChairmanCommittee on Surgical Training, Philippine College of Surgeo
ns2003
Foreword
1st Edition . . .
Gabriel L. Martinez
, MD, FPCS, Chairman,Committee on Surgical Training, Philippine College of Surge
ons1999
Message from the 2003 PCS President
Fernando A. Lopez
, MD, FPCS
Preface
2nd Edition . . .
Armando C. Crisostomo
, MD, FPCS,Regent-In-Charge (2003), Committee on Surgical Training,Philippine Co
llege of Surgeons
Preface
1st Edition . . .
Jose Y. Cueto
, MD, FPCS, Regent-In-Charge(1999), Committee on Surgical Training, Philippine C
ollege ofSurgeons
?
Chapter I
Learning & Assessing Psychomotor Skills inSurgery
Jose Y. Cueto, Jr.
, MD, MHPEd, FPCS (1st edition) Self-Assessment Questions
?
Chapter II
The Use of Simulation in Surgical Training
Shirard L.C. Adiviso
, MD, MHPEd, FPCS Self-assessment Questions
?
Chapter III
Suture Materials
Jose Antonio M. Salud
, MD, FPCS and
Jerome G. Baldonado
, MD, FPCS (1st edition)
Joey H. Bienvenida
, MD, FPCS (2nd edition) Self-assessment Questions
?
Chapter IV
Surgical Needles
Cenon R. Alfonso
, MD, FPCS and
Nilo C. de los Santos
, MD, FPCS (1st edition)
Renato A. Ocampo
, MD, FPCS (2nd edition) Self-assessment Questions
Table of Contents
?
Chapter V
Knot Tying
Jose Antonio M. Salud
, MD, FPCS (1st edition)
Miguel C. Mendoza
, MD, FPCS (2nd edition) Self-assessment Questions
?
Chapter VI
Suturing Techniques
Cenon R. Alfonso
, MD, FPCS,
Shirard L.C. Adiviso
, MD, MHPEd, FPCS,
Jose Joey H. Bienvenida
, MD, FPCS,
Miguel C. Mendoza
, MD, FPCS, and
Renato Cirilo A. Ocampo
, MD, FPCS (2nd edition) Self-assessment Questions
?
Chapter VII
Clinical Applications
Cenon R. Alfonso
, MD, FPCS,
Jerome G. Baldonado
, MD, FPCS,
Alejandro C. Dizon
, MD, FPCS,
Rene C. Encarnacion
, MD, FPCS,
Eduardo S. Eseque
, MD, FPCS,
Gabriel L. Martinez
, MD, FPCS,
Paul Jesus S. Montemayor
, MD, FPCS,
Jose Antonio M. Salud
, MD, FPCS, and
Jose A. Solomon
, MD, FPCS. Plastic Closure of Skin Lacerations Skin Closure with Skin Adhesives Abdom
inal Wall Closure Inguinal Herniorrhaphy/ Repair of the InguinalFloor Appendectomy Ch
olecystectomy & Surgery of the Bile Ducts Liver Trauma Bowel Anastomosis Vascular Anas
tomosis & Repair Application of Retention Sutures Self-assessment Questions
Appendix A
(Glossary of terms)
Appendix B
(Answers to self-assessment questions)
2003 PCS Board of Regents2003 Committee on Surgical TrainingAcknowledgement
You're reading a free preview.
Pages 4 to 23 are not shown in this preview.
READ THE FULL VERSION
You're Reading a Free Preview
Page 4 is not shown in this preview.
DOWNLOAD
You're Reading a Free Preview
48
THE WHO MANUAL OF DIAGNOSTIC IMAGING
avulsion of the medial epicondyle may be displaced into the joint mimicking the t
rochlea ossi?cationcentre.
Capitellar fractures
commonest purely intra-articular fracture of the elbow. fracture usually identi?ed
on lateral projection with fragment rotating anteriorly (?g 4.37). AP ?lm may appe
ar normal or show increased density due to the capitellar fragment overlying the
lateral epicondyle.
(a)(b)
Figure 4.36
(a) avulsion of the lateral epicondyle in a child withmarked displacement.(b) th
e lateral projection shows the radiocapitellar lineis disrupted indicating that
there is a dislocation of thehead of radius as well as the avulsion fracture.
Figure 4.37
Fracture of the capitellum. The capitellumhas rotated 90 degrees anteriorly.
TRAUMA
49
Radial head fractures
account for approximately one third of all elbow fractures. commonest in young adul
ts. spectrum of injury from minimally displaced to comminuted with displacement (?
g 4.38). in children tend to appear as a greenstick fracture of the radial neck ra
ther than a fracture of theradial head (?g 4.39).
Figure 4.38
Fracture of the radial head with minordisplacement.
Figure 4.39
Greenstick fracture of the neck of radius in a child.
Olecranon fractures
result from either a direct blow to the tip of the elbow or avulsion by contracti
on of the tricepsmuscle against a ?xed ?exed elbow. the action of the triceps freq
uently causes marked displacement of the olecranon at the fracturesite (?g 4.40)
.
Figure 4.40
Displaced fracture of the olecranon.
50
THE WHO MANUAL OF DIAGNOSTIC IMAGING
Elbow dislocation
third commonest site of dislocation in the adult after shoulder and ?ngers. commone
st site of dislocation in children under 10 years of age. 85% posterior or postero
lateral in direction (?g 4.41). 50% associated with fractures (?g 4.42).
Figure 4.41
Posterior dislocation of the elbow. (a) AP (b) lateral view.(a)(b)(a)(b)
Figure 4.42
Posterior dislocation of the elbow with a displaced fracture of the radial head.
Note that because of the severe trauma it is notalways possible to obtain ideal
AP (a) and lateral projections (b).
Activity (1)
FILTERSAdd to collectionReviewAdd NoteLike
1 hundred reads
Similar to Diagnostic Anatomy Radiographic
Merrills Pocket Guide to Radiography, 12E.pdf
Fundamentals of Special Radiographic Procedures Snopek Fundamentals Of
138277414 Radiographers
Atlas of Diagnostic Radiology
Recommended
Merrills Pocket Guide to Radiography, 12E.pdf
Isaac Contreras
Fundamentals of Special Radiographic Procedures Snopek Fundamentals Of
JUlio Daivys Cordero Sanchez
138277414 Radiographers
masood72
Atlas of Diagnostic Radiology
Alina Popovici
Previous|NextPage 1 of 8
Download and print this document
Read and print without ads
Download to keep your version
Edit, email or read offline
Choose a format:
.PDF.TXT
DOWNLOAD
ABOUT
Browse books
Browse documents
About Scribd
Meet the team
Our blog
Join our team!
Contact Us
SUPPORT
Help
FAQ
Press
Purchase help
AdChoices
PARTNERS
Publishers
Developers / API
LEGAL
Terms
Privacy
Copyright
MEMBERSHIPS
Join today
Invite Friends
Gifts
STAY CONNECTED
Scribd on Appstore
Scribd on Google Play
Copyright 2015 Scribd Inc. .Terms of service.Privacy.Mobile Site.Site Language:E
nglish
Search
UPLOADLIBRARY
BooksAudiobooks
DOWNLOADSTANDARD VIEWFULL VIEW
59
OF 96
73
1
/
11
/
11
/
11
/
11
/
11
/
1
DERMAL INSTRUMENTS
48
KEYES PUNCH
4
?
(102mm)KM 29-5112mmKM 29-5145mmKM 29-5123mmKM 29-5156mmKM 29-5134mmKM 29-5178mm
FOX CURETTE
5
1
/
2
?
(140mm)roundKM 29-4951mmKM 29-4984mmKM 29-4962mmKM 29-4995mmKM 29-4973mmKM 29-50
06mm
PIFFARD CURETTE
5
1
/
2
?
(140mm)ovalKM 29-503#1 smallKM 29-505#2 mediumKM 29-507#3 large
BIRO DERMAL NAEVUS SCISSORS
KM 35-5154
?
(102mm) angled on flatsharp outside edges
NAIL SPLITTER
Note: For a sure grip, our splitters have grooved handles.
2mm3mm4mm5mm6mm8mm1mm2mm3mm4mm5mm6mm
1
/
11
/
1
KM 29-505
1
/
1
KM 29-507
1
/
1
KM 29-503
1
/
1
KM 69-320KM 69-322KM 69-3264
?
(102mm)4
1
/
2
?
(114mm)5
?
(127mm)heavy jawKM 69-327KM 69-3405
?
(127mm) 6
?
(152mm)narrow jaw
1
/
1
DERMAL INSTRUMENTS
49
TISSUE NIPPERNAIL NIPPER
heavy
NAIL NIPPER
KM 69-410KM 69-4124
1
/
2
?
(114mm) concave5
1
/
2
?
(140mm) concavechromechromebarrel springbarrel spring
INGROWN NAIL FORCEPS
KM 69-3485
?
(127mm) anvil patternnarrow blade
FINGER RING CUTTER
KM 29-430KM 29-4346
1
/
2
?
(165mm) chromesaw blade onlywith saw blade
KM 69-2924
1
/
2
?
(114mm),11mmcutting edgeKM 69-2945
?
(127mm),14mmcutting edge
1
/
11
/
11
/
11
/
11
/
1
KM 69-4305
1
/
2
?
(140mm)concaveKM 69-4325
1
/
2
?
(140mm)straight
EYE INSTRUMENTS
50
BARRAQUER EYE SPECULUM
1
3
/
4
?
(44mm)KM 54-108KM 54-110small bladeslarge blades10mm wide15mm wide
GRAEFE EYE SPECULUM
KM 54-0803
1
/
2
?
(89mm)
DESMARRES LID RETRACTOR
5
1
/
2
?
(140mm)KM 54-358#111mmKM 54-360#213mmKM 54-362#315mmKM 54-364#417mm
MEYHOEFFER CURETTE
5
?
(127mm)KM 54-307#2/01.0mmKM 54-309#01.5mmKM 54-311#11.7mmKM 54-313#22.0mm
GRAEFE STRABISMUS HOOK
5
1
/
2
?
(140mm)KM 54-330smallKM 54-332mediumKM 54-334large
BOWMAN LACRIMAL PROBES
5
?
(127mm) sterling
11
/
11
/
11
/
1
EYE INSTRUMENTS
51
SCHIOTZ TONOMETER
KM 53-056straight scaleKM 53-058straight scale with Allen PlungerKM 53-060improv
ed, inclined scaleKM 53-062improved, inclined scale with Allen Plunger
CASTROVIEJO CALIPER
KM 53-0403
1
/
4
?
(83mm) graduated 0-20mm
DIX SPUD AND NEEDLE
KM 54-272in reversible screw handle
FOREIGN BODY NEEDLES AND SPUDS
NEEDLE
KM 54-2805
?
(127mm)2 x 5mm blade
DAVIS
KM 54-2824
3
/
4
?
(121mm)0.8mm blade
ELLIS
KM 54-2844
1
/
2
?
(114mm) curved1.2mm bladeKM 53-058KM 53-062
1
/
11
/
11
/
1
EYE INSTRUMENTS
52
BISHOP HARMAN FORCEPS
3
3
/
8
?
1
/
11
/
11
/
11
/
1
Activity (73)
FILTERSAdd to collectionReviewAdd NoteLike
Eric Ngunjiri liked this
anne0521 liked this
1 thousand reads
1 hundred reads
fatima liked this
sarah_stover_1 liked this
a_yeL liked this
Oliver Oyanup liked this
Andreea Salariu liked this
anil20009 liked this
Load more
Similar to General Surgical Instruments
Knot Tying Manual
Choose a format:
.PDF.TXT
DOWNLOAD
ABOUT
Browse books
Browse documents
About Scribd
Meet the team
Our blog
Join our team!
Contact Us
SUPPORT
Help
FAQ
Press
Purchase help
AdChoices
PARTNERS
Publishers
Developers / API
LEGAL
Terms
Privacy
Copyright
MEMBERSHIPS
Join today
Invite Friends
Gifts
STAY CONNECTED
Scribd on Appstore
Scribd on Google Play
Copyright 2015 Scribd Inc. .Terms of service.Privacy.Mobile Site.Site Language:E
nglish
Search
UPLOADLIBRARY
BooksAudiobooks
DOWNLOADSTANDARD VIEWFULL VIEW
95
OF 329
1
Atlas of Emergency Trauma
Ratings: (0)|Views: 294|Likes: 0
Published by Gabriela Ungureanu
Atlas of Emergency Trauma
A great atlas of Emergency Trauma
See more
You're reading a free preview.
Pages 7 to 123 are not shown in this preview.
READ THE FULL VERSION
You're Reading a Free Preview
Page 7 is not shown in this preview.
DOWNLOAD
You're Reading a Free Preview
Figure 4.3 (A
B) Plain radiographs of multiple mid rib fractures, with underlying lung contusi
on (A). Adequate analgesiawith epidural or patient-controlled analgesia should b
e considered early, especially in elderly patients. (C) 3-D reconstructionof mul
tiple mid rib fractures and a thoracostomy tube in place.
4.2 Rib Fractures 79
You're Reading a Free Preview
Page 94 is not shown in this preview.
DOWNLOAD
Fractures of the Lower (Ninthto Twelfth) Ribs
Fractures of the lower ribs are often associated withinjuries to the kidneys, li
ver, or spleen. Liberal use of abdominal CT scan should be considered.
Flail Chest
Flail chest is the result of anterior or lateraldouble fractures of at least thr
ee adjacent ribs. Inmost cases there is an underlying lung contusion.Clinically
the ?ail segment moves paradoxically to
Figure 4.4 (A) Radiograph showing fractures of the right lower ribs (arrows) (le
ft). Injuries to intra-abdominal solid organsare common and CT scan evaluation s
hould be considered. (B) Intraoperative photograph of the associated liver injur
yin the same patient.
AB
Figure 4.5 Flail chest. (A) Double fractures of at least three adjacent ribs are
required in order to produce a
??
ail chest.(B) Chest x-ray showing a left
??
ail chest with underlying lung contusion. (C) Patient with a
??
ail sternal segment; Note themidsternal depression (right).
80 Thoracic Injury
You're Reading a Free Preview
Page 95 is not shown in this preview.
DOWNLOAD
normal chest wall motion, and the patient may bein respiratory distress. All pat
ients with ?ail chestshould have a thoracostomy tube inserted and bemonitored in
an ICU setting with serial blood gasesand continuous pulse oximetry. Analgesia
by meansof PCA or epidural anesthesia should always beused. Mechanical ventilati
on is necessary forrespiratory failure or imminent failure. Internal,operative f
racture ?xation may be useful in selectedcases without underlying lung contusion
and inpatients having dif?culty weaning off mechanicalventilation.
4.3 Hemo-Pneumothorax
Pneumothorax
A pneumothorax may be due to blunt or penetra-ting trauma. Small pneumothoraces
are usuallyasymptomatic and can safely be managed withouta chest drain, provided
the patient does not needmechanical ventilation or air transportation. Inthese
cases, any size pneumothorax should betreated with a thoracostomy tube to avoid
thecreation of tension pneumothorax. Large pneu-mothoraces may cause respiratory
distress, andtension pneumothoraces can cause cardiorespira-tory failure. The d
iagnosis of simple pneumo-thorax is usually made by plain chest ?lm orCT scan. A
n erect chest x-ray in deep expirationis the most suitable ?lm to identify small
pneumothoraces.
Tension Pneumothorax
In tension pneumothorax, air leaks into the pleuralcavity with no escape route o
Publi24
Android
? Top
Cautare
Home
Meteo
Fata zilei
Download
Arhiva
Stiri
Localitati
Video
Sport
Timp
liber
Capitala
Culturala
Turism
Joburi
Publi24
Android
Logare
TION Pag. de start
Tion
Web
Videoclipuri
Cautare
EVENIMENT
GALERIE FOTO Trei raniti, printre care si un copil, la spital dupa ce un sofer n
u a acordat prioritate
Trei raniti, printre care si un copil, la spital dupa ce un sofer nu a acordat p
rioritate
Accident de circula?ie, duminica dupa-amiaza, n centrul localita?ii timi?ene Chi?
oda. Trei persoane, printre care ?i un copil, au ajuns la spital dupa ce ma?inil
e n care se aflau s-au ciocnit violent din cauza unui ?ofer care nu a acordat pri
oritate.
Trei raniti, printre care si un copil, la spital dupa ce un sofer nu a acordat p
rioritate
ROMNIA
STIRE DE ULTIMA ORA Dacian Ciolos si-a ales guvernul
Dacian Ciolos si-a ales guvernul
Premierul desemnat, Dacian Ciolo?, ?i-a prezentat duminica dupa-amiaza, la Parla
ment, guvernul. Luni ?i mar?i ar urma audierile mini?trilor propu?i n comisiile d
e specialitate din Parlament, apoi votul de investitura n plenul reunit al Camere
i Deputa?ilor ?i Senatului. Lista mini?trilor.
ADMINISTRATIE
GALERIE FOTO Sensul giratoriu de la stadion e gata, dar nu poate fi folosit. Pro
bleme pe santierul Podeanu
Sensul giratoriu de la stadion e gata, dar nu poate fi folosit. Probleme pe sant
ierul Podeanu
Sunt probleme pe nca un ?antier din Timi?oara. De?i ar fi trebuit sa fie gata nca
din luna septembrie, strada Podeanu nu va fi deschisa circula?iei prea curnd. Nou
l sens giratoriu de la stadion, inclus n proiect, este amenajat, dar nu va putea
etean Timisoara.
POLITIC
PNL Timis vrea alegeri anticipate: parlamentarii sa-si dea demisia in bloc
PNL Timis vrea alegeri anticipate: parlamentarii sa-si dea demisia in bloc
Conducerea PNL Timi? considera ca na?ional liberalii au o ?ansa reala la alegeri
le de anul viitor. Unul dintre liderii filialei este de parere ca un guvern de t
ehnocra?i nu trebuie sa fie unul de cursa lunga, iar parlamentarii ar trebui sa?i dea demisia n bloc ?i sa fie organizate alegeri anticipate. 6
ANUNTURI
yorkshire mini toy
yorkshire mini toy
Samsung Note 4
Samsung Note 4
Vand bratara barbati aur 14 K
Vand bratara barbati aur 14 K
LOCAL
Soarta comunitatilor maghiare dispersate, dezbatuta la Timisoara
Soarta comunitatilor maghiare dispersate, dezbatuta la Timisoara
La Timisoara se desfasoara duminica, 15 noiembrie, Ziua Diasporei Maghiare. Nu m
ai putin de 55 de delegati din noua judete se afla n urbea de pe Bega pentru a de
zbate soarta acestor comunitati dispersate. Momentul principal este adoptarea pl
practic se decide care sunt principalele actiuni care trebuie
anului de actiune
desfasurate pentru mentinerea acestor comunitati dispersate.
EVENIMENT
GALERIE FOTO Accident mortal aproape de Moravita. Doi oameni au murit
Accident mortal aproape de Moravita. Doi oameni au murit
Accident grav de circula?ie, pe drumul care leaga Moravi?a de localitatea Oravi?
a, smbata dupa-amiaza. Doi barba?i ?i-au pierdut via?a, dupa ce ma?ina n care se a
flau s-a izbit violent de un autobuz plin cu muncitori.
UPDATE. Un cititor Tion.ro a fost martor la accident ?i ne-a trimis imagini de l
a locul impactului. 1
Accident mortal aproape de Moravita
TURISM
Cele mai vechi locuri din lume: top 10 destinatii antice care au marcat omenirea
Cele mai vechi locuri din lume: top 10 destinatii antice care au marcat omenirea
Cei fascina?i de istorie nu ar trebui sa rateze o excursie ntr-una dintre aceste
locuri incredibile, care debordeaza de istorie ?i legende. Nimic nu se compara c
u o plimbare printre ruinele locurilor unde au luat na?tere primele civilizatii
ale lumii.
PARTY
GALERIE FOTO Timisoara, alaturi de victimele din Colectiv! #ImpreunaRezistam a s
trans zeci de mii de lei
Timisoara, alaturi de victimele din Colectiv! #ImpreunaRezistam a strans zeci de
mii de lei
#mpreunaRezistam! Acesta a fost mesajul transmis de 16 trupe timi?orene, care au
urcat pe scena pentru a sus?ine victimele tragicului accident din Colectiv. De?i
vremea nu a fost tocmai prietenoasa, cteva sute de timi?oreni au ie?it din case
?i au donat sume substan?iale pentru cei care au fost afecta?i de incendiul din
clubul bucure?tean.
#ImpreunaRezistam a strans zeci de mii de lei din donatii
MAPAMOND
Microbuz inmatriculat in Romania, rasturnat in Ungaria: soferul a murit si noua
pasageri, raniti
Microbuz inmatriculat in Romania, rasturnat in Ungaria: soferul a murit si noua
pasageri, raniti
Un microbuz nmatriculat n Romnia s-a rasturnat dupa ce a lovit un autoturism n sud-e
stul Ungariei. n urma impactului, ?oferul microbuzului, o femeie, a murit, iar n
oua pasageri au fost rani?i.
ANUNTURIProprietar, vand apartament 3 camere din 4, Dacia
Bilantul terorii de la Paris: cel putin 120 de morti in mai multe atacuri terori
ste
MAPAMOND
Cel putin cinci persoane au murit dupa ce un tren a deraiat in Franta
Cel putin cinci persoane au murit dupa ce un tren a deraiat in Franta
nca un incident ?ocant n Fran?a. Cel pu?in cinci persoane au murit, smbata dupa-ami
aza, dupa ce un tren a deraiat n nordul ora?ul francez Strasbourg.
LOCAL
GALERIE FOTO Mitropolitul Banatului si-a celebrat ziua de nastere cu nevoiasii,
la cantina din Iosefin
Mitropolitul Banatului si-a celebrat ziua de nastere cu nevoiasii, la cantina di
n Iosefin
Mitropolitul Banatului PSS Ioan si-a aniversat ziua de nastere alaturi de saracii
Timi?oarei, la cantina sociala din Parohia Iosefin, care a fost inaugurata smbat
a, dupa ce a trecut prin mai multe renovari. 2
Mitropolitul Banatului si-a celebrat ziua de nastere cu nevoiasii, la cantina di
n Iosefin
ADMINISTRATIE
Mii de timisoreni pusi pe drumuri pentru taxa de poluare. Robu: vina este a Dire
ctiei Fiscale
Mii de timisoreni pusi pe drumuri pentru taxa de poluare. Robu: vina este a Dire
ctiei Fiscale
Nu mai pu?in de 8.000 de timi?oreni au primit soma?ii de la Direc?ia Fiscala, fi
ind chema?i la sediul institu?iei sa achite taxa de poluare, de?i au firme cu ac
tivita?i care nu produc impact asupra mediului. Cum pot scapa de plata taxei? 8
Vrei sa iti scoti copilul minor din tara? Iti trebuie cazier judiciar
LOCAL
Vrei sa iti scoti copilul minor din tara? Iti trebuie cazier judiciar
Daca inten?iona?i sa pleca?i n vacan?a n strainatate alaturi de minori, Poli?ia Ro
mna anun?a ca pe lnga celelalte documente prevazute de lege, persoana care i nso?e?t
e pe copii trebuie sa aiba la ea certificatul de cazier judiciar. 3
LOCAL
Atentionare meteo: doua zile de vant puternic in Banat
Atentionare meteo: doua zile de vant puternic in Banat
Meteorologii au transmis, smbata, o aten?ionare de vnt puternic valabila pentru ac
est sfr?it de saptamna n mai multe regiuni ale ?arii, inclusiv Banat. Astfel, vntul
va atinge, la rafala, viteze de pna la 60 km/h.
LOCAL
Mitropolitul Banatului despre atentatele de la Paris: Inima Frantei a sangerat
Mitropolitul Banatului despre atentatele de la Paris: Inima Frantei a sangerat
ntreaga lume a fost socata n urma tragediei petrecute n capitala Frantei, vineri se
ara. Cel pu?in 120 de persoane au murit ?i alte cteva sute au fost ranite, dintre
care 99 sunt n stare grava, n urma atentatelor. Mitropolitul Banatului PS Ioan a u
rmarit evenimentele petrecute n capitala Frantei si a ramas nmarmurit n fata aceste
i tragedii. 3
LOCAL
Timisoara intra in #Colectiv la concertul #ImpreunaRezistam
Timisoara intra in #Colectiv la concertul #ImpreunaRezistam
Smbata, ntreaga Romnie va comemora, prin muzica, victimele tragicului accident din
Colectiv. Concertul #mpreunaRezistam va avea loc, simultan, n diferite ora?e din ?
ara. Desigur, Timi?oara se numara printre ele, iar to?i banii ob?inu?i de pe urm
a evenimentului vor ajunge la victimele incendiului din capitala. Publicul va pu
tea sa faca ?i dona?ii. 1
ADMINISTRATIE
GALERIE FOTO Inaugurare marca primarie: Robu merge cu troleibuzul la Dumbravita,
calatorii inca nu
Inaugurare marca primarie: Robu merge cu troleibuzul la Dumbravita, calatorii in
ca nu
A fost nchis n sfr?it ?antierul de pe Calea Lipovei. De?i troleibuzul 14 ar fi treb
uit sa circule pna la Dumbravi?a nca de la nceputul saptamnii, acest lucru nu se va n
1 | 2 | 3 | 4 | 5 | 6
Meteo
InfoTrafic
Horoscop
Cinema
dum 15
Cum va fi vremea, duminica, 15. noiembrie 2015: 13 C (Timisoara)
13C
lun 16
Cum va fi vremea, luni, 16. noiembrie 2015: 17 C (Timisoara)
17C
mar 17
Cum va fi vremea, mar?i, 17. noiembrie 2015: 18 C (Timisoara)
18C
Vremea in Timisoara
Fata Zilei
Video
Urmareste-ne pe:
TOP ARTICOLE
Live
Vizualizate 24h
Comentate
Bilantul terorii de la Paris: cel putin 120 de morti in mai multe atacuri teror
iste 34
Inaugurare marca Primaria Timisoara: Robu merge cu troleibuzul la Dumbravita, c
alatorii inca nu 27
Vaporase ca in Amsterdam, la Timisoara. Stim cand vine prima ambarcatiune 17
ULTIMELE STIRI
14:55 Trei raniti, printre care si un copil, la ...
13:51 Rezidentiat 2015: viitorii medici, in examen ...
12:59 Numarul ungurilor din Timis e in scadere. ...
12:44 Fara apa si caldura, luni, pe doua strazi din ...
12:28 Sensul giratoriu de la stadion e aproape ...
JOCURI FLASH
Bubble Deluxe
Bubble Deluxe
Green Archer 2
Green Archer 2
Castle Clout
Double Edged
Golf Jam
Golf Jam
Mai multe jocuri >>>
Cele mai recente locuri de munca in turism: hoteluri si vase de croaziera
RSS Feed Widget
Anunturi online publitim
Video Live
TionTV: Tanar ucis de un elev la cativa pasi de o scoala din Timisoara
TionTV: Tanar ucis de un elev la cativa pasi de o scoala din Timisoara
TionTV: Criminalii din Complexul Studentesc, dusi la reconstituire
TionTV: Criminalii din Complexul Studentesc, dusi la reconstituire
TionTV: Detalii socante in dosarul crimei din Complexul Studentesc
TionTV: Detalii socante in dosarul crimei din Complexul Studentesc
Protest in Piata Operei din Timisoara: mii de timisoreni, alaturi de manifestant
ii din Bucuresti
Protest in Piata Operei din Timisoara: mii de timisoreni, alaturi de manifestant
ii din Bucuresti
TionTV: Circulatia tramvaielor, blocata de un bizon care a trecut pe rosu
TionTV: Circulatia tramvaielor, blocata de un bizon care a trecut pe rosu
TionTV: Incendiu in trafic, la Timisoara
TionTV: Incendiu in trafic, la Timisoara
Party in Timis
Timisoara, alaturi de victimele de la Colectiv! #ImpreunaRezistam a strans zeci
de mii de lei din donatii
Timisoara, alaturi de victimele de la Colectiv! #ImpreunaRezistam a strans zeci
de mii de lei din donatii
#ImpreunaRezistam a strans zeci de mii de lei din donatii
Revolutia Muzicala de la Timisoara s-a anulat! Nu s-a gasit nicio locatie pentru
eveniment
Revolutia Muzicala de la Timisoara s-a anulat! Nu s-a gasit nicio locatie pentru
eveniment
Un club din Complexul Studentesc isi suspenda activitatea. Conducerea spune ca d
e vina e primaria
Un club din Complexul Studentesc isi suspenda activitatea. Conducerea spune ca d
e vina e primaria
LOCAL
Bicicleta furata din bloc, in timpul zilei
Alta bicicleta furata din bloc la Timisoara. Furtul a avut loc n timpul zilei, nu
la adapostul ntunericului. Campania Ti s-a furat bicicleta, TION te ajuta sa o ga
sesti! vrea sa faca lumina n acest caz si n alte situatii n care bicicletele le-au f
ost rapite proprietarilor.
LOCAL
Bicicleta furata din fata blocului in interval de 20 de minute
O alta bicicleta s-a furat la Timisoara. Este vorba despre o bicicleta furata de
pe bulevardul Corneliu Coposu din Timisoara, chiar din fata blocului. Campania T
i s-a furat bicicleta, TION te ajuta sa o gasesti! continua!
LOCAL
Bicicleta furata din scara blocului, din cartierul Freidorf
Furturile de biciclete din Timisoara continua. Ca si n alte cazuri, s-a furat din
nou o bicicleta din scara blocului. Campania Ti s-a furat bicicleta, TION te aju
ta sa o gasesti!
LOCAL
continua.
Trei biciclete furate din Timisoara. Unul dintre pagubiti i-a vazut pe posibilii
suspecti
Alte trei biciclete au fost furate din Timisoara n ultima perioada. Pagubitii vor
sa si le recupereze. Ajutati-i n acest demers! Campania Ti s-a furat bicicleta, T
ION te ajuta sa o gasesti! continua.
LOCAL
Bicicleta furata de la... etajul trei, la Timisoara
O alta bicicleta a fost furata la Timisoara. n aceasta perioada se pare ca hotii
actioneaza n interior. Si aceasta bicicleta, la fel ca si altele, a fost furata di
n casa scarii. Campania Ti s-a furat bicicleta, TION te ajuta sa o gasesti! contin
ua.
LOCAL
Bicicleta furata din scara blocului, la Timisoara
Vremea din ce n ce mai rece face ca biciclistii sa mai lase vehiculele cu doua ro
ti acasa. Oricum, unii dintre ei le mai folosesc. Daca le au, pentru ca unii au
ramas fara ele n urma actiunilor neobositilor hoti de biciclete din Timisoara. In
diferent de anotimp, campania Ti s-a furat bicicleta, TION te ajuta sa o gasesti!
continua!
LOCAL
Bicicleta furata de sub fereastra apartamentului, la Timisoara
Hotii de biciclete actioneaza asiduu n aceste zile la Timisoara. Unui locuitor al
urbei de pe Bega i-a fost furata bicicleta chiar de sub geam. Campania Ti s-a fu
rat bicicleta, TION te ajuta sa o gasesti! continua.
LOCAL
Bicicleta furata in urma cu un an, reperata in trafic. Proprietarul ofera recomp
ensa
La un an dupa ce bicicleta i-a fost furata, a vazut-o din nou, n trafic. Acum, pa
gubitul are din nou sperante ca o va regasi, mai ales ca nu sunt multe astfel de
modele n oras. Campania Ti s-a furat bicicleta, TION te ajuta sa o gasesti! pune u
marul, mpreuna cu dumneavoastra, la depistarea vehiculului cu doua roti care a fo
st furat de lnga proprietar n urma cu un an.
LOCAL
Hoti inventivi la Timisoara - bicicleta furata cu lemnul
O bicicleta a fost furata din zona Printul Turcesc din Timisoara. Hotii au dat d
ovada de inventivitate n cazul acestui furt. Campania Ti s-a furat bicicleta, TION
te ajuta sa o gasesti! continua.
LOCAL
Bicicleta furata de la etajul IV, dintr-un bloc din Timisoara. Pagubitul crede c
a s-a actionat la pont
Furtul de biciclete ia amploare n Timisoara. Acum, cnd vara este aproape de sfrsit,
hotii dau spargeri dupa spargeri si fura vehiculele cu doua roti. Campania Ti sa furat bicicleta, TION te ajuta sa o gasesti! continua!
LOCAL
Hotii au tras cortina peste mersul pe doua roti. Un actor a ramas fara bicicleta
la Timisoara
Hotii actioneaza n continuare n forta n Timisoara, atunci cnd vine vorba de biciclet
e. Recent au furat bicicleta unui actor care colaboreaza cu Teatrul National Tim
isoara. Campania Ti s-a furat bicicleta, TION te ajuta sa o gasesti! continua.
LOCAL
Servicii
Newsletter
RSS
Redactia
Russmedia Press
Termeni si conditii
Parteneri
Auto
Anunturi
Imobiliare
Infomariaj
Retete culinare
TION 2015
Ce v-ar interesa sa gasiti in paginile noastre?
Trimiteti-ne sugestiile voastre
Numele tau:
Adresa ta de e-mail:
Trimite
Color Atlas Of Ultrasound Anatomy.pdf FREE Download
Color Atlas Of Ultrasound Anatomy.pdf Full Download
75 MB
added 26 minutes ago
http://mediafire.com/?jo2aiqh...
Download via MediaFire
Color Atlas Of Ultrasound Anatomy.pdf
http://www.mediafire.com/?yy3mmo...
79.26 MB added 3 years ago
Download via MediaFire
Atlas Of Human Anatomy For The Artist.pdf
http://www.mediafire.com/?lxh5t3...
86.9 MB
added 3 years ago
Download via MediaFire
An Atlas Of Animal Anatomy For Artists.pdf
http://www.mediafire.com/?7nldfi... 28.02 MB added 3 years ago
Download via MediaFire
Color Atlas Of Physiology. 6th Ed.pdf
http://www.mediafire.com/?do51ho...
13.65 MB added 3 years ago
Download via MediaFire
Transcri'+'pt-acland-s-dvd-atlas-of-human-anatomy.pdf
http://www.mediafire.com/?phxv14...
1018.03 MB added 3 years ago
Download via MediaFire
Color Atlas Of Diagnostic Microbiology.pdf
http://www.mediafire.com/?ztzj1j...
26.29 MB added 3 years ago
Download via MediaFire
Three-dimensional Cephalometry A Color Atlas And Manual.pdf
http://www.mediafire.com/?xniudf...
26.68 MB added 3 years ago
Download via MediaFire
Three-dimensional Cephalometry - A Color Atlas And Manual.pdf
http://www.mediafire.com/?ihdmmz...
26.68 MB added 3 years ago
Download via MediaFire
(by Dr.mohamed Abdelsttar) Color Atlas Of Parasitology.pdf
http://www.mediafire.com/?y7fud2...
20.91 MB added 3 years ago
Download via MediaFire
Color Atlas Of Veterinary Pathology (second Edition).part1.rar
http://www.mediafire.com/?zmaxzo...
152.59 MB
added 3 years ago
Download via MediaFire
Ferri's Color Atlas & Text Of Clinical Medicine.rar
http://www.mediafire.com/?c49mue... 78.53 MB added 3 years ago