Utilization of alteplase in trauma victim with an open abdomen.

Trauma victims with multisystem injuries are at risk for the development of deep vein thrombosis and pulmonary embolus (PE). The use of thrombolytic therapy remains very controversial and not well-documented in both the postsurgical and trauma subset of patients. Major trauma, surgery or head injury have been noted as absolute contraindications to thrombolysis in acute myocardial infarction.

Determining competency in the sexually assaulted patient: a decision algorithm.

The determination of competency for decisions regarding one's care is of great individual importance as it represents a basic human right. Often, in Emergency Nursing, we are presented with situations that require difficult decisions that must be made in a brief time frame. The role of the Sexual Assault Nurse Examiner (SANE) in providing assessment and care to victims of assault is crucial to initiating the restoration of health and dignity of the patient in a tragic set of circumstances.

Management of embedded foreign body: penetrating stab wound to the head.

Penetrating craniocerebral trauma is an injury in which a projectile violates the skull but does not exit. The significance of penetrating injuries to the head depends largely on the circumstances of the injury, the velocity of impact, and attributes of the projectile. While most penetrating head injuries are caused by firearms, lower-velocity mechanisms of penetrating brain injury present unique challenges for the multidisciplinary team involved with the delivery of care.

Surgical management of traumatic L2-L3 spondyloptosis.

Subluxation of a vertebra secondary to an injury (ie, traumatic spondyloptosis) is most commonly seen in the lumbosacral joint. This extremely rare spinal destabilization is caused by congenital defects, degeneration, tumors, infection, or trauma and is accompanied by severe neurologic debilitation. The patient's neurological function can be preserved when surgical team members have knowledge of spinal injuries, surgical interventions, positioning and its implications, and an awareness of the risks to the patient.