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19 results

Trauma
  • A Comprehensive Emergency Medicine Approach
  • Edited by Eric Legome, Lee W. Shockley
  • Published online:
    07 September 2011
    Print publication:
    16 June 2011
  • Trauma: A Comprehensive Emergency Medicine Approach is a fully illustrated, interdisciplinary overview of trauma. Using both evidence-based approaches and a practical understanding of the emergency department, it gives a broad and in-depth review of trauma care. The entire spectrum of trauma presentations is reviewed from minor soft-tissue injuries through to major life-threatening conditions. Written by over 50 expert contributors, it gives concrete and practical recommendations for evaluation, treatment, consultation and disposition decisions on both common and unusual conditions. Extensive use of photographs, illustrations and key information boxes is used to make the material accessible. Additional sections provide an overview of multiple other issues relating to emergency management of trauma including administrative, nursing, research and legal matters. This book provides an essential reference for anyone who is called upon to provide acute trauma care in the emergency department.

  • 15 - Crying and irritability

  • Swaminatha V. Mahadevan, Stanford University School of Medicine, California, Gus M. Garmel, Stanford University School of Medicine, California
  • Book:
    An Introduction to Clinical Emergency Medicine
    Published online:
    27 October 2009
    Print publication:
    26 May 2005, pp 217-224

  • Summary

    Scope of the problem

    Small children cry and cry and cry. In part, this is due to the limited repertoire of communication skills they possess. They cry because crying is remarkably effective; there is no other infant behavior that elicits an adult's attention and response more reliably than the cry. At 2 weeks of age, the average crying time of a normal infant is 2 hours per day. By age 6 weeks, that increases to nearly 3 hours per day. Fortunately, it decreases to about 1 hour per day by 12 weeks of age.

    Inconsolable crying is a very challenging presentation for several reasons: the child (usually under 2 years of age) may have nonspecific symptoms (or no symptoms at all except for the crying), and the associated diseases can range from benign to life-threatening. Inconsolable crying is also very challenging for parents. The primary focus of the emergency practitioner should be to search for and rule out serious causes of crying and irritability. Benign etiologies, although more common, should be established only after first considering the serious etiologies.

    Pathophysiology

    Crying is one of the only ways by which an infant communicates discomfort or distress. In that sense, it is a nonspecific form of communication. However, the infant's cry is probably more than a distress signal. Studies of the acoustic qualities of infant cries indicate that the cry probably contains “encoded” messages about the state of early neurologic development.