Major trauma - Knowledge

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Injury affects more males; 68% of injuries occur in males and death from trauma is twice as common in males as it is in females, this is believed to be because males are much more willing to engage in risk-taking activities. Teenagers and young adults are more likely to need hospitalization from injuries than other age groups. While elderly persons are less likely to be injured, they are more likely to die from injuries sustained due to various physiological differences that make it more difficult for the body to compensate for the injuries. The primary causes of traumatic death are central nervous system injuries and

347: 889: 418: 1038:. One reason for the high cost of the treatment for trauma is the increased possibility of complications, which leads to the need for more interventions. Maintaining a trauma center is costly because they are open continuously and maintain a state of readiness to receive patients, even if there are none. In addition to the direct costs of the treatment, there also is a burden on the economy due to lost wages and productivity, which in 2009, accounted for approximately 1016:, Kenya, are claimed to show major trauma—both blunt and penetrating—caused by violent trauma to the head, neck, ribs, knees, and hands, which has been interpreted by some researchers as establishing the existence of warfare between two groups of hunter-gatherers 10,000 years ago. The evidence for blunt-force trauma at Nataruk has been challenged, however, and the interpretation that the site represents an early example of warfare has been questioned. 6131: 6143: 508:

population. Injury prevention strategies generally involve educating the general public about specific risk factors and developing strategies to avoid or reduce injuries. Legislation intended to prevent injury typically involves seatbelts, child car-seats, helmets, alcohol control, and increased enforcement of the legislation. Other controllable factors, such as the use of drugs including

409:. Injuries that may manifest themselves later may be missed during the initial assessment, such as when a patient is brought into a hospital's emergency department. Generally, the physical examination is performed in a systematic way that first checks for any immediate life threats (primary survey), and then taking a more in-depth examination (secondary survey). 988: 6170: 1059:

pre-hospital care system that treats injured persons initially and transports them to hospital quickly, resulting in most casualty patients being transported by private vehicles. Also, their hospitals lack the appropriate equipment, organizational resources, or trained staff. By 2020, the amount of trauma-related deaths is expected to decline in

863:. Immediate access to care may be crucial to prevent death in persons experiencing major trauma. Late deaths occur days or weeks after the injury and often are related to infection. Prognosis is better in countries with a dedicated trauma system where injured persons are provided quick and effective access to proper treatment facilities. 1154:

Due to anatomical and physiological differences, injuries in children need to be approached differently from those in adults. Accidents are the leading cause of death in children between 1 and 14 years old. In the United States, approximately sixteen million children go to an emergency department due

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personnel, emergency department assessment, treatment, stabilization, and in-hospital care among all age groups. An established trauma system network is also an important component of community disaster preparedness, facilitating the care of people who have been involved in disasters that cause large

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that may lead to death, if not corrected. The main principle of the procedure involves performing the fewest procedures to save life and limb; less critical procedures are left until the victim is more stable. Approximately 15% of all people with trauma have abdominal injuries, and approximately 25%

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was of high importance in the pre-hospital setting, but due to lack of evidence to support its use, the practice is losing favor. Instead, it is recommended that more exclusive criteria be met such as age and neurological deficits to indicate the need of these adjuncts. This may be accomplished with

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The body responds to traumatic injury both systemically and at the injury site. This response attempts to protect vital organs such as the liver, to allow further cell duplication and to heal the damage. The healing time of an injury depends on various factors including sex, age, and the severity of

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it is often not possible until after imaging, or the person has improved. After immediate life threats are controlled, a person is either moved into an operating room for immediate surgical correction of the injuries, or a secondary survey is performed that is a more detailed head-to-toe assessment

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Trauma is the sixth leading cause of death worldwide, resulting in five million or 10% of all deaths annually. It is the fifth leading cause of significant disability. About half of trauma deaths are in people aged between 15 and 45 years and trauma is the leading cause of death in this age group.

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decreases death in people who are having ongoing bleeding due to trauma, as well as those with mild to moderate traumatic brain injury and evidence of intracranial bleeding on CT scan. It only appears to be beneficial, however, if administered within the first three hours after trauma. For severe

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were given to people who had poor perfusion due to trauma. This is still appropriate in cases with isolated extremity trauma, thermal trauma, or head injuries. In general, however, giving lots of fluids appears to increase the risk of death. Current evidence supports limiting the use of fluids for

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Management of those with trauma often requires the help of many healthcare specialists including physicians, nurses, respiratory therapists, and social workers. Cooperation allows many actions to be completed at once. Generally, the first step of managing trauma is to perform a primary survey that

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or trauma center, and received a trauma diagnosis that caused a negative change in their health-related quality of life, with a potential to create anxiety and symptoms of depression. New preserved blood products also are being researched for use in pre-hospital care; it is impractical to use the

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By identifying risk factors present within a community and creating solutions to decrease the incidence of injury, trauma referral systems may help to enhance the overall health of a population. Injury prevention strategies are commonly used to prevent injuries in children, who are a high risk

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countries (LMICs) often have higher mortality rates from injury. These countries accounted for 89% of all deaths from injury worldwide. Many of these countries do not have access to sufficient surgical care and many do not have a trauma system in place. In addition, most LMICs do not have a

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Shakur H, Roberts I, Bautista R, Caballero J, Coats T, Dewan Y, El-Sayed H, Gogichaishvili T, et al. (CRASH-2 trial) (2010). "Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised,

461:. Where blood pressure is low or the heart rate is increased—likely from bleeding in the abdomen—immediate surgery bypassing a CT scan is recommended. Modern 64-slice CT scans are able to rule out, with a high degree of accuracy, significant injuries to the neck following blunt trauma. 2942:

Wang, CH; Hsieh, WH; Chou, HC; Huang, YS; Shen, JH; Yeo, YH; Chang, HE; Chen, SC; Lee, CC (Dec 11, 2013). "Liberal Versus Restricted Fluid Resuscitation Strategies in Trauma Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Observational Studies".

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followed by ventilation, though intubating in shock due to bleeding can lead to arrest, and should be done after some resuscitation whenever possible. Trauma resuscitation includes control of active bleeding. When a person is first brought in, vital signs are checked, an

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Indications for intubation include airway obstruction, inability to protect the airway, and respiratory failure. Examples of these indications include penetrating neck trauma, expanding neck hematoma, and being unconscious. In general, the method of intubation used is

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while some evidence has found it may be harmful. Hospitals with designated trauma centers have improved outcomes when compared to hospitals without them, and outcomes may improve when persons who have experienced trauma are transferred directly to a trauma center.

130:) may be necessary to prevent loss of life or limb. The initial assessment is critical, and involves a physical evaluation and also may include the use of imaging tools to determine the types of injuries accurately and to formulate a course of treatment. 1029:

The financial cost of trauma includes both the amount of money spent on treatment and the loss of potential economic gain through absence from work. The average financial cost for the treatment of traumatic injury in the United States is approximately

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is undertaken to identify any life-threatening problems, after which the secondary examination is carried out. This may occur during transportation or upon arrival at the hospital. The secondary examination consists of a systematic assessment of the

782:—a protein that assists blood clotting—may be appropriate. While it decreases blood use, it does not appear to decrease the mortality rate. In those without previous factor VII deficiency, its use is not recommended outside of trial situations. 49: 4773: 4758: 163: 205:

are used commonly to quantify injuries for the purpose of triaging and allow a system to monitor or "trend" a patient's condition in a clinical setting. The data also may be used in epidemiological investigations and for research purposes.

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Rapid transportation of severely injured patients improves the outcome in trauma. Helicopter EMS transport reduces mortality compared to ground-based transport in adult trauma patients. Before arrival at the hospital, the availability of

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to some form of injury every year, with boys being more frequently injured than girls by a ratio of 2:1. The world's five most common unintentional injuries in children as of 2008 are road crashes, drowning, burns, falls, and poisoning.

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if the bleeding continues. Conditions such as impending airway obstruction, enlargening neck hematoma, or unconsciousness require intubation. It is unclear, however, if this is best performed before reaching hospital or in the hospital.

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agent, but not oral administration. There are concerns that intravenous contrast administration in trauma situations without confirming adequate renal function may cause damage to kidneys, but this does not appear to be significant.

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Most research on trauma occurs during war and military conflicts as militaries will increase trauma research spending in order to prevent combat related deaths. Some research is being conducted on patients who were admitted into an

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sometimes are used in hemorrhagic shock as a result of trauma, there is a lack of evidence for their use. Therefore, as of 2012 they have not been recommended. Allowing a low blood pressure may be preferred in some situations.

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For statistical purposes, injuries are classified as either intentional such as suicide, or unintentional, such as a motor vehicle collision. Intentional injury is a common cause of traumas. Penetrating trauma is caused when a

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In 2002, unintentional and intentional injuries were the fifth and seventh leading causes of deaths worldwide, accounting for 6.23% and 2.84% of all deaths. For research purposes the definition often is based on an

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Singletary, Eunice M.; Charlton, Nathan P.; Epstein, Jonathan L.; Ferguson, Jeffrey D.; Jensen, Jan L.; MacPherson, Andrew I.; Pellegrino, Jeffrey L.; Smith, William “Will” R.; Swain, Janel M. (2015-11-03).

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Improvements in pre-hospital care have led to "unexpected survivors", where patients survive trauma when they would have previously been expected to die. However these patients may struggle to rehabilitate.

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Hauser CJ, Boffard K, Dutton R, et al. (September 2010). "Results of the CONTROL trial: efficacy and safety of recombinant activated Factor VII in the management of refractory traumatic hemorrhage".

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Kanji, HD; Neitzel, A; Sekhon, M; McCallum, J; Griesdale, DE (Apr 2014). "Sixty-four-slice computed tomographic scanner to clear traumatic cervical spine injury: systematic review of the literature".

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Allen TL, Mueller MT, Bonk RT, Harker CP, Duffy OH, Stevens MH (2004). "Computed tomographic scanning without oral contrast solution for blunt bowel and mesenteric injuries in abdominal trauma".

3287:"Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial" 762:

are in development; however, as of 2013 there are none available for commercial use in North America or Europe. These products are only available for general use in South Africa and Russia.

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is an important part of managing trauma in children because the accurate dosing of medicine may be critical for resuscitative efforts. A number of methods to estimate weight, including the

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The decision whether to perform surgery is determined by the extent of the damage and the anatomical location of the injury. Bleeding must be controlled before definitive repair may occur.

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The care of acutely injured people in a public health system requires the involvement of bystanders, community members, health care professionals, and health care systems. It encompasses

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Ringdal M, Plos K, Lundberg D, Johansson L, Bergbom I (2009). "Outcome after injury: memories, health-related quality of life, anxiety, and symptoms of depression after intensive care".

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Kannus, P.; Parkkari, J.; Jarvinen, T.; Jarvinen, A.; Jarvinen, M. (June 2003). "Basic science and clinical studies coincide: active treatment approach is needed after a sports injury".

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Simpson, E; Lin, Y; Stanworth, S; Birchall, J; Doree, C; Hyde, C (Mar 14, 2012). "Recombinant factor VIIa for the prevention and treatment of bleeding in patients without haemophilia".

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has been found to improve survival and lower overall blood product use; a ratio of 1:1:1 is recommended. The success of platelets has been attributed to the fact that they may prevent

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Neal MD, Peitzman AB, Forsythe RM, et al. (February 2011). "Over reliance on computed tomography imaging in patients with severe abdominal injury: is the delay worth the risk?".

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techniques improves the chances of a person surviving the journey to the nearest trauma-equipped hospital. Emergency medicine services determines which people need treatment at a

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Nirula R, Maier R, Moore E, Sperry J, Gentilello L (2010). "Scoop and run to the trauma center or stay and play at the local hospital: hospital transfer's effect on mortality".

1000:. Various classification scales exist for use with trauma to determine the severity of injuries, which are used to determine the resources used and, for statistical collection. 166:. The purpose of the matrix is for international standardization of the classification of trauma. Major trauma sometimes is classified by body area; injuries affecting 40% are 4344:

Rosenberg M, Greenberger S, Rawal A, Latimer-Pierson J, Thundiyil J (June 2011). "Comparison of Broselow tape measurements versus physician estimations of pediatric weights".

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Long-term prognosis frequently is complicated by pain; more than half of trauma patients have moderate to severe pain one year after injury. Many also experience a reduced

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is performed, and, if needed, vascular access is obtained. Other tests should be performed to get a baseline measurement of their current blood chemistry, such as an

5967: 1201:, shock may be more difficult to diagnose. Where the woman is more than 23 weeks pregnant, it is recommended that the fetus be monitored for at least four hours by 647:

evaluates a person's airway, breathing, circulation, and neurologic status. These steps may happen simultaneously or depend on the most pressing concern such as a

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Huber-Wagner S, Lefering R, Qvick LM, et al. (2009). "Effect of whole-body CT during trauma resuscitation on survival: a retrospective, multicentre study".

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The initial assessment is critical in determining the extent of injuries and what will be needed to manage an injury, and for treating immediate life threats.

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Stojanowski, Christopher M.; Seidel, Andrew C.; Fulginiti, Laura C.; Johnson, Kent M.; Buikstra, Jane E. (24 Nov 2016). "Contesting the Massacre at Nataruk".

835:, severe brain or high spinal cord injury, or rupture of the heart or of large blood vessels. Early deaths occur within minutes to hours and often are due to 249:, creating an open wound. In the United States, most deaths caused by penetrating trauma occur in urban areas and 80% of these deaths are caused by firearms. 5987: 5731: 2860: 3144: 6093: 5982: 1198: 4199: 5415: 4346: 3123: 2220:. Atlanta, Georgia: National Center for Injury Prevention and Control Centers for Disease Control and Prevention Atlanta, Georgia. 2006. pp. 35–101. 5959: 3735:

Feinstein, A; Dolan, Ray (1991). "Predictors of post-traumatic stress disorder following physical trauma: an examination of the stressor criterion".

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Korley FK, Pham JC, Kirsch TD (2010). "Use of advanced radiology during visits to US emergency departments for injury-related conditions,1998–2007".

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Cap AP, Baer DG, Orman JA, Aden J, Ryan K, Blackbourne LH (July 2011). "Tranexamic acid for trauma patients: a critical review of the literature".

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Other medications may be used in conjunction with other procedures to stabilize a person who has sustained a significant injury. While positive

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So TY, Farrington E, Absher RK (2009). "Evaluation of the accuracy of different methods used to estimate weights in the pediatric population".

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Lahr, M. Mirazón; Rivera, F.; Power, R. K.; Mounier, A.; Copsey, B.; Crivellaro, F.; Edung, J. E.; Fernandez, J. M. Maillo; Kiarie, C. (2016).

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Rivara FP, Mackenzie EJ, Jurkovich GJ, Nathens AB, Wang J, Scharfstein DO (2008). "Prevalence of pain in patients 1 year after major trauma".

1489:"Pre-hospital care management of a potential spinal cord injured patient: a systematic review of the literature and evidence-based guidelines" 1181:

Trauma occurs in approximately 5% of all pregnancies, and is the leading cause of maternal death. Additionally, pregnant women may experience

516:, increases the risk of trauma by increasing the likelihood of traffic collisions, violence, and abuse occurring. Prescription drugs such as 217:

Injuries may be caused by any combination of external forces that act physically against the body. The leading causes of traumatic death are

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may decrease blood return to the heart, it may be very beneficial to lay a woman in late pregnancy on her left side. also recommended are

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Injuries generally are classified by either severity, the location of damage, or a combination of both. Trauma also may be classified by

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of these require exploratory surgery. The majority of preventable deaths from trauma result from unrecognised intra-abdominal bleeding.

445:, known as pan-scans, improve the survival rate of those who have suffered major trauma. These scans use intravenous injections for the 319: 4671: 4652: 4633: 4467: 4300: 4064: 3884: 3701: 3582: 3553: 2998: 2201: 1959:"Comparison of whole-body computed tomography vs selective radiological imaging on outcomes in major trauma patients: a meta-analysis" 1851: 1752: 1697: 1629: 1604: 1579: 1554: 1356: 1208:

A number of treatments beyond typical trauma care may be needed when the patient is pregnant. Because the weight of the uterus on the

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trauma, it may be beneficial to have a highly trained health care provider available to maintain airway, breathing, and circulation.

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a patient or for statistical analysis. Injury scales measure damage to anatomical parts, physiological values (blood pressure etc.),

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Mock C, Quansah R, Krishnan R, Arreola-Risa C, Rivara F (June 2004). "Strengthening the prevention and care of injuries worldwide".

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Fitzgerald, J.E.F.; Larvin, Mike (2009). "Chapter 15: Management of Abdominal Trauma". In Baker, Qassim; Aldoori, Munther (eds.).

481:, often are used in cases of severe blunt trauma to the chest or abdomen, especially when a person is experiencing early signs of 5842: 5784: 5724: 5321: 4877: 3515: 3342:

Napolitano, LM; Cohen, MJ; Cotton, BA; Schreiber, MA; Moore, EE (June 2013). "Tranexamic acid in trauma: how should we use it?".

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has been shown to cause birth defects, although the doses used for typical exams generally are considered safe. Due to normal

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is a complex cause of trauma because it commonly includes both blunt and penetrating trauma, and also may be accompanied by a

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years after an injury, with 20% of victims sustaining some form of disability. Physical trauma may lead to development of

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due to trauma chest compressions are considered futile, but still recommended. Correcting the underlying cause such as a

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McGillicuddy EA, Schuster KM, Kaplan LJ, et al. (2010). "Contrast-induced nephropathy in elderly trauma patients".

1839: 470: 433:(FAST) exam to check for internal bleeding. For those with relatively stable blood pressure, heart rate, and sufficient 421:

Whole body radiograph of traumatic injuries notable for fractures of both femurs (thigh bones), indicating major trauma

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after injury occurs to protect against further damage and starts the healing process. Prolonged inflammation may cause

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Various scales exist to provide a quantifiable metric to measure the severity of injuries. The value may be used for

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Andrew B., MD Peitzman; Andrew B. Peitzman; Michael, MD Sabom; Donald M., MD Yearly; Timothy C., MD Fabian (2002).

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Vanden Hoek TL, Morrison LJ, Shuster M, Donnino M, Sinz E, Lavonas EJ, Jeejeebhoy FM, Gabrielli A (2010-11-02).

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Taheri PA, Butz DA, Lottenberg L, Clawson A, Flint LM (January 2004). "The cost of trauma center readiness".

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https://royalsociety.org/-/media/about-us/industry/tof-conference-reports/trauma-recovery-report-2020.pdf

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currently available blood products in a timely fashion in remote, rural settings or in theaters of war.

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or major arterial bleed. The primary survey generally includes assessment of the cervical spine, though

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Ulvik A, Kvåle R, Wentzel-Larsen T, Flaatten H (2008). "Quality of life 2–7 years after major trauma".

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Greer SE, Rhynhart KK, Gupta R, Corwin HL (2010). "New developments in massive transfusion in trauma".

874:(PTSD). One study has found no correlation between the severity of trauma and the development of PTSD. 237:

or impaled objects. Subsets of blunt trauma are both the number one and two causes of traumatic death.

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Ahn, H; Singh, J; Nathens, A; MacDonald, RD; Travers, A; Tallon, J; Fehlings, MG; Yee, A (Aug 2011).

648: 458: 389: 150:, such as age or gender. It also may be classified by the type of force applied to the body, such as 4168: 2899:

Roppolo LP, Wigginton JG, Pepe PE (2010). "Intravenous fluid resuscitation for the trauma patient".

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penetrating thorax and abdominal injuries, allowing mild hypotension to persist. Targets include a

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Nemeth, J; Maghraby, N; Kazim, S (May 2012). "Emergency airway management: the difficult airway".

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of 70–90 mmHg, or the re-establishment of peripheral pulses and adequate ability to think.

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As no intravenous fluids used for initial resuscitation have been shown to be superior, warmed

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Trauma deaths occur in immediate, early, or late stages. Immediate deaths usually are due to

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does not greatly improve the outcome for major trauma when compared to the administration of

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Approximately 2% of those who have experienced significant trauma have a spinal cord injury.

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Andrew B., Peitzman; Michael, MD Sabom; Donald M., MD Yearly; Timothy C., MD Fabian (2002).

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continues to be the solution of choice. If blood products are needed, a greater use of

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as well as assessing for disability and gaining exposure to check for other injuries.

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Discussion document on injury severity measurement in administrative datasets

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areas, a complete inspection of the body surface to find all injuries, and a

326:. Immediately after injury, the body increases production of glucose through 6029: 5914: 5881: 5657: 5648: 5590: 5535: 5091: 4767: 4213: 3574: 3219: 335: 331: 4606: 4555: 4520: 4402: 4394: 4367: 4269: 4232: 4154: 4117: 4034: 3991: 3932: 3848: 3717: 3663: 3628: 3493: 3452: 3407: 3363: 3328: 3271: 3228: 3168: 3073: 3038: 2964: 2920: 2876: 2834: 2815: 2781: 2728: 2651: 2616: 2567: 2532: 2475: 2436: 2349: 2299: 2258:"Prehospital Use of Cervical Collars in Trauma Patients: A Critical Review" 2172: 2134: 2099: 2064: 2056: 2029: 1994: 1935: 1900: 1818: 1666: 1522: 1438: 1313: 4688:

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has been studied and found to be of little difference from normal saline.

5939: 5929: 5924: 5616: 5516: 5355: 4324: 1288:"Major trauma and the injury severity score—where should we set the bar?" 1105: 786: 737: 362: 4750: 4462:. Upper Saddle River, N.J: Brady/Prentice Hall Health. pp. 239–47. 4026: 3983: 2514: 696:

exam may help assess for internal bleeding. In certain traumas, such as

5460: 4086: 3443: 1063:, while in low- to middle-income countries it is expected to increase. 1009: 521: 513: 394: 366: 351: 277:

The symptoms of injury may manifest in many different ways, including:

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629:. Evidence is inconclusive in determining support for pre-hospital 5634: 5625: 5425: 3789:"Death and DALY estimates for 2004 by cause for WHO Member States" 1141: 986: 887: 832: 585:

as well as provide primary stabilization by checking and treating

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Health care providers attending to a person on a stretcher with a

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in those who are 24 to 34 weeks and may need delivery or a

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Deaths from injuries per 100,000 inhabitants in 2004

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Persons with major trauma commonly have chest and pelvic

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ATLS: Advanced Trauma Life Support Program for Doctors

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corpsman listens for the correct tube placement on an

489:, likely because of bleeding in the abdominal cavity, 6158: 4666:. Hagerstwon, MD: Lippincott Williams & Wilkins. 3875:

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hemorrhages in the outer meningeal layer of the brain

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is used to manage severe trauma in which there is a

6103: 6016: 5958: 5907: 5818: 5747: 5676: 5599: 5566: 5507: 5459: 5436: 5309: 5284: 5248: 5197: 5074: 5067: 5047: 5006: 4999: 4974: 4941: 4934: 4893: 4818: 4744: 4714:Zajtchuk, R; Bellamy, RF; Grande, CM, eds. (1995). 457:scans are performed on 15% of those with trauma in 310:Various organ systems respond to injury to restore 69: 42: 4485:"Emergency Medicine: Lessons from the battlefield" 2450:Sullivent, EE; Faul, M; Wald, MM (Jul–Sep 2011). 1840:Committee on Trauma, American College of Surgeons 1199:physiological changes that occur during pregnancy 469:Surgical techniques, using a tube or catheter to 314:by maintaining perfusion to the heart and brain. 2993:. New York: McGraw-Hill Companies. p. 176. 1193:. There are diagnostic issues during pregnancy; 5968:International Federation for Emergency Medicine 3687: 3685: 3683: 3681: 2151:Hoyt, DB; Coimbra, R (2007). "Trauma systems". 5972:International Conference on Emergency Medicine 1266:National Highway Traffic Safety Administration 5725: 5409: 4987:Focused assessment with sonography for trauma 4871: 3870: 3868: 3866: 2664:Anes - Combat Anesthesia: The First 24 Hours 1874: 1872: 1692:. London, England: Hodder Arnold Publishers. 991:Incidence of accidents by activity in Denmark 491:cutting through the abdominal wall surgically 431:focused assessment with sonography for trauma 8: 5988:Canadian Association of Emergency Physicians 4847:Emergency Medicine Research and Perspectives 3344:The Journal of Trauma and Acute Care Surgery 2749: 2747: 1008:The human remains discovered at the site of 604:other medical transport devices, such as a 536:numbers of casualties, such as earthquakes. 365:are visible within and around the shattered 6094:Care of the Critically Ill Surgical Patient 5983:Australasian College for Emergency Medicine 3898: 3896: 3171:. Archived from the original on 2012-07-24. 2894: 2892: 2890: 2709:Emergency Medicine Clinics of North America 2146: 2144: 1834: 1832: 1830: 1828: 1738: 1736: 1570:Dickenson ET, Limmer D, O'Keefe MF (2009). 1419:Emergency Medicine Clinics of North America 1342: 1340: 1338: 1336: 1334: 1332: 5732: 5718: 5710: 5416: 5402: 5394: 5071: 5003: 4938: 4878: 4864: 4856: 4741: 4430: 4428: 4426: 4424: 4422: 4420: 4347:The American Journal of Emergency Medicine 3285:CRASH-3 trial collaborators (2019-11-09). 3118: 3116: 3012: 3010: 2363:Karbi, OA; Caspari, DA; Tator, CH (1988). 1743:Sutin, Kenneth M; Marino, Paul L. (2007). 1417:Bonatti, H; Calland, JF (2008). "Trauma". 94:that has the potential to cause prolonged 48: 39: 4596: 4510: 4222: 4212: 4107: 3922: 3838: 3756: 3516:"Vasopressor and Inotrope Usage in Shock" 3483: 3442: 3318: 3218: 2984: 2982: 2824: 2814: 2771: 2606: 2522: 2382: 2331: 2289: 1984: 1974: 1690:Manual of Definitive Surgical Trauma Care 1512: 1412: 1410: 1303: 102:. There are many causes of major trauma, 5978:American College of Emergency Physicians 4645:Trauma, Seventh Edition (Trauma (Moore)) 3816: 3814: 3812: 3743:(1). Cambridge University Press: 85–91. 3145:"Artificial O2 carriers: status in 2005" 2854: 2852: 2850: 2848: 2846: 2844: 1408: 1406: 1404: 1402: 1400: 1398: 1396: 1394: 1392: 1390: 1081: 6165: 5998:European Society for Emergency Medicine 3423:Cochrane Database of Systematic Reviews 2795:Krausz AA, El-Naaj IA, Barak M (2009). 1253: 324:systemic inflammatory response syndrome 245:such as a bullet or a knife enters the 6008:American Academy of Emergency Medicine 4437:"Trauma In Pregnancy: Double Jeopardy" 4057:PHTLS: Prehospital Trauma Life Support 3944: 3942: 3718:"309.81 Posttraumatic Stress Disorder" 3174: 4849:(emergency medicine procedure videos) 3019:The Surgical Clinics of North America 2417:The Surgical Clinics of North America 7: 6003:Asian Society for Emergency Medicine 4569:Alam HB, Velmahos GC (August 2011). 2370:Canadian Medical Association Journal 6088:Advanced Life Support in Obstetrics 5993:Royal College of Emergency Medicine 5317:Acute respiratory distress syndrome 3910:The New England Journal of Medicine 3903:Norton R, Kobusingye O (May 2013). 3571:Clinical Surgery: A Practical Guide 884:List of preventable causes of death 520:may increase the risk of trauma in 320:multiple organ dysfunction syndrome 4628:. London, England: Hodder Arnold. 2802:World Journal of Emergency Surgery 1622:Introduction to Emergency Medicine 587:airway, breathing, and circulation 25: 4458:Campbell, John Creighton (2000). 4321:"UN raises child accidents alarm" 2773:10.1161/CIRCULATIONAHA.110.971069 2638:(3): 595–99, discussion 599–601. 2153:Surgical Clinics of North America 2022:10.1097/01.TA.0000058118.86614.51 197:, or a combination of those. The 6168: 6141: 6130: 6129: 5785:International emergency medicine 5322:Chronic traumatic encephalopathy 4694:(3rd ed.). Washington, DC: 3656:10.1111/j.1399-6576.2007.01533.x 3485:10.1111/j.1742-6723.2009.01210.x 3466:Senz, A; Nunnink, L (Oct 2009). 1659:10.1034/j.1600-0838.2003.02225.x 1549:. McGraw-Hill. pp. 227–33. 1224:in the event of cardiac arrest. 1046:Low- and middle-income countries 760:hemoglobin-based oxygen carriers 750:Cell salvage and autotransfusion 6142: 6082:Pediatric Advanced Life Support 5795:Pre-hospital emergency medicine 631:intravenous fluid resuscitation 471:drain fluid from the peritoneum 330:and its consumption of fat via 6070:Acute Care of at-Risk Newborns 6064:Neonatal Resuscitation Program 5373:Post-traumatic stress disorder 3827:The British Journal of Surgery 3823:"Epidemiology of major trauma" 3472:Emergency Medicine Australasia 3435:10.1002/14651858.CD005011.pub4 2989:Tintinalli, Judith E. (2010). 1620:Medzon R, Mitchell EJ (2005). 1545:DiPrima Jr., PA (2008-03-21). 1216:in those who are rh negative, 872:post-traumatic stress disorder 529:pre-hospital trauma assessment 1: 6052:Advanced cardiac life support 6035:Cardiopulmonary resuscitation 4571:"New trends in resuscitation" 4435:Tibbles, Carrie (July 2008). 4262:10.1016/S0140-6736(04)16510-0 4147:10.1016/j.amjsurg.2003.06.002 3615:(3): 282–87, discussion 288. 3303:10.1016/S0140-6736(19)32233-0 3211:10.1016/S0140-6736(10)60835-5 1928:10.1016/S0140-6736(09)60232-4 6076:Pediatric basic life support 6058:Advanced trauma life support 6041:Mouth-to-mouth resuscitation 5790:Pediatric emergency medicine 5014:Advanced trauma life support 4982:Diagnostic peritoneal lavage 4647:. McGraw-Hill Professional. 4589:10.1067/j.cpsurg.2011.04.002 3066:10.1097/ACO.0b013e328336ea59 2957:10.1097/CCM.0000000000000050 2913:10.1097/MCC.0b013e32833bf774 2560:10.1097/MCC.0b013e3282f1e77e 2468:10.3109/10903127.2011.569849 2333:10.1161/CIR.0000000000000269 1811:10.1016/j.injury.2004.12.037 1375:. Center for Disease Control 599:and placing the person on a 595:by securing the neck with a 479:pericardium around the heart 350:Radiograph of a close-range 306:Increased rate of metabolism 61:to the head; the patient is 6196:Critical emergency medicine 4576:Current Problems in Surgery 4548:10.1097/TA.0b013e318181b8e3 4503:10.1136/bmj.39568.496424.94 4441:Emergency Medicine Practice 4134:American Journal of Surgery 3400:10.1097/TA.0b013e3181edf36e 3356:10.1097/ta.0b013e318292cc54 3264:10.1097/TA.0b013e31822114af 3197:placebo-controlled trial". 3143:Spahn DR, Kocian R (2005). 2865:Emergency Medicine Practice 2859:Cherkas, David (Nov 2011). 2644:10.1097/TA.0b013e3181ee6e32 2092:10.1097/TA.0b013e31820930f9 1893:10.1097/TA.0b013e3181cf7e40 1727:10.1383/surg.21.9.240.16923 774:bleeding, for example from 708:Traditionally, high-volume 606:Kendrick extrication device 6232: 5760:Emergency medical services 5556:Retroperitoneal hemorrhage 4360:10.1016/j.ajem.2009.12.002 4100:10.1016/j.surg.2008.05.003 3161:10.2174/138161205774913354 2456:Prehospital Emergency Care 2127:10.1016/j.jcrc.2013.10.022 1231: 1075: 881: 730:Lactated Ringer's solution 533:emergency medical services 500: 138:(ISS) of greater than 15. 26: 6124: 5055:Resuscitative thoracotomy 4943:Clinical prediction rules 4174:. National Safety Council 3796:World Health Organization 3758:21.11116/0000-0001-A23A-7 3749:10.1017/S0033291700014689 3181:: CS1 maint: unfit URL ( 3031:10.1016/j.suc.2012.08.006 2721:10.1016/j.emc.2011.12.005 2429:10.1016/j.suc.2006.09.009 2165:10.1016/j.suc.2006.09.012 1976:10.1186/s13049-014-0054-2 1688:Boffard, Kenneth (2007). 1599:. London: Hodder Arnold. 1574:. Pearson Prentice Hall. 1431:10.1016/j.emc.2008.05.001 662:rapid sequence intubation 593:Spinal motion restriction 56: 47: 5935:Epinephrine / Adrenaline 4951:Abbreviated Injury Scale 3621:10.1001/archsurg.2007.61 2871:(11): 1–19, quiz 19-20. 2115:Journal of Critical Care 689:, if present, may help. 577:The pre-hospital use of 407:neurological examination 223:motor vehicle collisions 199:Abbreviated Injury Scale 116:motor vehicle collisions 5182:Penetrating head injury 5177:Intracranial hemorrhage 4214:10.1186/1757-7241-20-64 3644:Acta Anaesthesiol Scand 2766:(18 Suppl 3): S829–61. 2326:(18 suppl 2): S574–89. 2186:Walker, Bonnie (1996). 1036:cardiovascular diseases 780:recombinant factor VIIa 719:systolic blood pressure 556:trauma victim during a 29:Trauma (disambiguation) 5378:Subcutaneous emphysema 5337:Volkmann's contracture 5187:Traumatic brain injury 5024:Early appropriate care 5019:Damage control surgery 4483:Gulland A (May 2008). 4395:10.1542/peds.2008-1968 3737:Psychological Medicine 2945:Critical Care Medicine 2816:10.1186/1749-7922-4-21 2405:Moore 2013, pp. 154–66 2262:Journal of Neurotrauma 2057:10.1001/jama.2010.1408 1493:Journal of Neurotrauma 1214:Rho(D) immune globulin 1042:in the United States. 998:substantial blood loss 992: 984: 845:blood around the lungs 804:Damage control surgery 742:packed red blood cells 715:mean arterial pressure 569: 561: 422: 377: 6116:Injury Severity Score 5887:Nasopharyngeal airway 5860:Intraosseous infusion 5663:Occupational injuries 5152:Thoracic aorta injury 5112:Diaphragmatic rupture 4956:Injury Severity Score 4926:Trauma triad of death 4691:Emergency War Surgery 4319:(December 10, 2008). 3924:10.1056/NEJMra1109343 3252:The Journal of Trauma 3054:Curr Opin Anesthesiol 2595:Health Technol Assess 2274:10.1089/neu.2013.3094 2192:. Greenwood. p. 1505:10.1089/neu.2009.1168 1451:Moore 2013, pp. 77–98 1061:high-income countries 990: 891: 882:Further information: 787:inotropic medications 687:pericardial tamponade 623:advanced life support 567: 547: 459:emergency departments 420: 349: 282:Altered mental status 136:Injury Severity Score 5893:Oropharyngeal airway 5770:Emergency psychiatry 5755:Emergency department 5668:Traumatic amputation 5327:Compartment syndrome 4966:Revised Trauma Score 4059:. Mosby/JEMS. 2010. 3577:. pp. 192–204. 3297:(10210): 1713–1723. 2316:"Part 15: First Aid" 2218:CDC Injury Fact Book 1785:Pietzman 2002, p. 19 1776:Pietzman 2002, p. 17 1767:Pietzman 2002, p. 21 849:air around the lungs 649:tension pneumothorax 390:physical examination 384:Physical examination 290:Increased heart rate 162:, which is based on 27:For other uses, see 6191:Medical emergencies 5872:Tracheal intubation 5866:Intravenous therapy 5162:Blunt kidney trauma 5132:Pulmonary contusion 4027:10.1038/nature19778 3984:10.1038/nature16477 3976:2016Natur.529..394L 3100:Wall street Journal 2901:Curr Opin Crit Care 2548:Curr Opin Crit Care 2515:10.1503/cmaj.071154 1241:intensive care unit 1183:placental abruption 1067:Special populations 1020:Society and culture 734:fresh frozen plasma 717:of 60 mmHg, a 675:thromboelastography 568:Typical trauma room 465:Surgical techniques 453:In the U.S., CT or 6046:Basic life support 5950:Sodium bicarbonate 5748:Emergency medicine 5741:Emergency medicine 5631:Penetrating trauma 5551:Grey Turner's sign 5541:Subungual hematoma 5276:Spinal cord injury 5235:Penetrating trauma 5102:Soft tissue injury 4819:External resources 4626:Trauma Care Manual 4497:(7653): 1098–100. 3821:Søreide K (2009). 3597:Moore 2013, p. 330 3258:(1 Suppl): S9–14. 2741:Moore 2013, p. 161 2697:Moore 2013, p. 163 2688:Moore 2013, p. 160 2601:(23): iii, 1–103. 2159:(1): 21–35, v–vi. 1597:Trauma care manual 1286:Palmer, C (2007). 1210:inferior vena cava 1195:ionizing radiation 993: 985: 812:metabolic acidosis 776:bleeding disorders 752:also may be used. 710:intravenous fluids 704:Intravenous fluids 671:arterial blood gas 627:basic life support 570: 562: 487:low blood-pressure 443:Full-body CT scans 423: 378: 231:penetrating trauma 203:Glasgow Coma Scale 156:penetrating trauma 76:Emergency medicine 6156: 6155: 5945:Magnesium sulfate 5854:Electrocardiogram 5780:Medical emergency 5765:Emergency nursing 5707: 5706: 5391: 5390: 5305: 5304: 5147:Internal bleeding 5142:Cardiac tamponade 5097:Joint dislocation 5063: 5062: 4995: 4994: 4842: 4841: 4664:The trauma manual 4256:(9427): 2172–79. 3948:Moore 2013, p. 23 3694:The Trauma Manual 3546:The trauma manual 3102:. 8 December 2012 2715:(2): 401–20, ix. 1922:(9673): 1455–61. 1326:Moore 2013, p. 77 1222:caesarean section 1159:Weight estimation 1152: 1151: 1094:Traffic collision 1040:US$ 693.5 billion 982: 981: 756:Blood substitutes 748:from developing. 723:Hypertonic saline 610:hemostatic agents 558:search and rescue 503:Injury prevention 148:demographic group 85: 84: 37:Medical condition 16:(Redirected from 6223: 6173: 6172: 6171: 6164: 6145: 6144: 6133: 6132: 5734: 5727: 5720: 5711: 5699:Abdominal trauma 5607:Ballistic trauma 5494:Friction blister 5489:Fracture blister 5418: 5411: 5404: 5395: 5297:Pediatric trauma 5292:Geriatric trauma 5256:Abdominal trauma 5072: 5004: 4939: 4880: 4873: 4866: 4857: 4742: 4732: 4730: 4729: 4710: 4708: 4707: 4698:. Archived from 4696:Borden Institute 4677: 4658: 4639: 4611: 4610: 4600: 4566: 4560: 4559: 4531: 4525: 4524: 4514: 4480: 4474: 4473: 4455: 4449: 4448: 4432: 4415: 4414: 4378: 4372: 4371: 4341: 4335: 4334: 4332: 4331: 4313: 4307: 4306: 4288: 4282: 4281: 4243: 4237: 4236: 4226: 4216: 4190: 4184: 4183: 4181: 4179: 4173: 4165: 4159: 4158: 4128: 4122: 4121: 4111: 4077: 4071: 4070: 4053: 4047: 4046: 4021:(7630): E8–E10. 4010: 4004: 4003: 3970:(7586): 394–98. 3955: 3949: 3946: 3937: 3936: 3926: 3900: 3891: 3890: 3872: 3861: 3860: 3842: 3840:10.1002/bjs.6643 3818: 3807: 3806: 3804: 3803: 3793: 3785: 3779: 3778: 3760: 3732: 3726: 3725: 3714: 3708: 3707: 3689: 3676: 3675: 3639: 3633: 3632: 3604: 3598: 3595: 3589: 3588: 3566: 3560: 3559: 3541: 3535: 3534: 3532: 3530: 3520: 3512: 3506: 3505: 3487: 3463: 3457: 3456: 3446: 3418: 3412: 3411: 3382: 3376: 3375: 3339: 3333: 3332: 3322: 3282: 3276: 3275: 3247: 3241: 3240: 3222: 3220:20.500.12959/415 3193: 3187: 3186: 3180: 3172: 3155:(31): 4099–114. 3149:Curr. Pharm. Des 3140: 3134: 3133: 3131: 3130: 3120: 3111: 3110: 3108: 3107: 3092: 3086: 3085: 3049: 3043: 3042: 3014: 3005: 3004: 2986: 2977: 2976: 2939: 2933: 2932: 2896: 2885: 2884: 2879:. Archived from 2856: 2839: 2838: 2828: 2818: 2792: 2786: 2785: 2775: 2751: 2742: 2739: 2733: 2732: 2704: 2698: 2695: 2689: 2686: 2680: 2674: 2668: 2662: 2656: 2655: 2627: 2621: 2620: 2610: 2586: 2580: 2579: 2543: 2537: 2536: 2526: 2494: 2488: 2487: 2447: 2441: 2440: 2423:(1): 37–53, vi. 2412: 2406: 2403: 2397: 2396: 2386: 2360: 2354: 2353: 2335: 2310: 2304: 2303: 2293: 2253: 2247: 2246: 2244: 2243: 2234:. Archived from 2228: 2222: 2221: 2214: 2208: 2207: 2183: 2177: 2176: 2148: 2139: 2138: 2121:(2): 314.e9–13. 2110: 2104: 2103: 2075: 2069: 2068: 2040: 2034: 2033: 2005: 1999: 1998: 1988: 1978: 1954: 1948: 1947: 1911: 1905: 1904: 1876: 1867: 1864: 1858: 1857: 1836: 1823: 1822: 1792: 1786: 1783: 1777: 1774: 1768: 1765: 1759: 1758: 1740: 1731: 1730: 1710: 1704: 1703: 1685: 1679: 1678: 1642: 1636: 1635: 1617: 1611: 1610: 1592: 1586: 1585: 1567: 1561: 1560: 1542: 1536: 1535:Moore 2013, p. 2 1533: 1527: 1526: 1516: 1484: 1478: 1477: 1475: 1474: 1468: 1458: 1452: 1449: 1443: 1442: 1414: 1385: 1384: 1382: 1380: 1369: 1363: 1362: 1347:Marx, J (2010). 1344: 1327: 1324: 1318: 1317: 1307: 1283: 1277: 1276: 1274: 1272: 1258: 1203:cardiotocography 1088:Deaths per year 1082: 1078:Pediatric trauma 1041: 1033: 975: 969: 963: 957: 951: 945: 937: 931: 925: 919: 913: 907: 901: 895: 857:liver laceration 740:instead of only 677:. In those with 601:long spine board 485:. In those with 363:Birdshot pellets 180:abdominal trauma 52: 40: 21: 6231: 6230: 6226: 6225: 6224: 6222: 6221: 6220: 6206:Causes of death 6181: 6180: 6179: 6169: 6167: 6159: 6157: 6152: 6120: 6104:Scoring systems 6099: 6012: 5954: 5903: 5814: 5743: 5738: 5708: 5703: 5672: 5595: 5562: 5503: 5499:Sucking blister 5479:Delayed blister 5455: 5432: 5422: 5392: 5387: 5301: 5280: 5244: 5193: 5068:Pathophysiology 5059: 5043: 4991: 4970: 4930: 4889: 4884: 4853: 4843: 4838: 4837: 4814: 4813: 4753: 4739: 4727: 4725: 4713: 4705: 4703: 4687: 4684: 4682:Further reading 4674: 4661: 4655: 4642: 4636: 4623: 4620: 4615: 4614: 4568: 4567: 4563: 4533: 4532: 4528: 4482: 4481: 4477: 4470: 4457: 4456: 4452: 4434: 4433: 4418: 4389:(6): e1045–51. 4380: 4379: 4375: 4343: 4342: 4338: 4329: 4327: 4323:. London: BBC. 4317:BBC News Online 4315: 4314: 4310: 4303: 4290: 4289: 4285: 4245: 4244: 4240: 4192: 4191: 4187: 4177: 4175: 4171: 4167: 4166: 4162: 4130: 4129: 4125: 4079: 4078: 4074: 4067: 4055: 4054: 4050: 4012: 4011: 4007: 3957: 3956: 3952: 3947: 3940: 3917:(18): 1723–30. 3902: 3901: 3894: 3887: 3874: 3873: 3864: 3820: 3819: 3810: 3801: 3799: 3791: 3787: 3786: 3782: 3734: 3733: 3729: 3716: 3715: 3711: 3704: 3691: 3690: 3679: 3641: 3640: 3636: 3606: 3605: 3601: 3596: 3592: 3585: 3568: 3567: 3563: 3556: 3543: 3542: 3538: 3528: 3526: 3518: 3514: 3513: 3509: 3465: 3464: 3460: 3429:(3): CD005011. 3420: 3419: 3415: 3384: 3383: 3379: 3341: 3340: 3336: 3284: 3283: 3279: 3249: 3248: 3244: 3205:(9734): 23–32. 3195: 3194: 3190: 3173: 3142: 3141: 3137: 3128: 3126: 3122: 3121: 3114: 3105: 3103: 3094: 3093: 3089: 3051: 3050: 3046: 3016: 3015: 3008: 3001: 2988: 2987: 2980: 2941: 2940: 2936: 2898: 2897: 2888: 2858: 2857: 2842: 2794: 2793: 2789: 2753: 2752: 2745: 2740: 2736: 2706: 2705: 2701: 2696: 2692: 2687: 2683: 2675: 2671: 2663: 2659: 2629: 2628: 2624: 2608:10.3310/hta8230 2588: 2587: 2583: 2545: 2544: 2540: 2496: 2495: 2491: 2449: 2448: 2444: 2414: 2413: 2409: 2404: 2400: 2362: 2361: 2357: 2312: 2311: 2307: 2255: 2254: 2250: 2241: 2239: 2230: 2229: 2225: 2216: 2215: 2211: 2204: 2185: 2184: 2180: 2150: 2149: 2142: 2112: 2111: 2107: 2077: 2076: 2072: 2051:(13): 1465–71. 2042: 2041: 2037: 2007: 2006: 2002: 1956: 1955: 1951: 1913: 1912: 1908: 1878: 1877: 1870: 1865: 1861: 1854: 1838: 1837: 1826: 1794: 1793: 1789: 1784: 1780: 1775: 1771: 1766: 1762: 1755: 1742: 1741: 1734: 1712: 1711: 1707: 1700: 1687: 1686: 1682: 1644: 1643: 1639: 1632: 1619: 1618: 1614: 1607: 1594: 1593: 1589: 1582: 1569: 1568: 1564: 1557: 1544: 1543: 1539: 1534: 1530: 1486: 1485: 1481: 1472: 1470: 1466: 1460: 1459: 1455: 1450: 1446: 1416: 1415: 1388: 1378: 1376: 1371: 1370: 1366: 1359: 1346: 1345: 1330: 1325: 1321: 1285: 1284: 1280: 1270: 1268: 1260: 1259: 1255: 1250: 1236: 1230: 1218:corticosteroids 1191:uterine rupture 1179: 1167:Leffler formula 1080: 1074: 1069: 1048: 1039: 1031: 1027: 1022: 1006: 983: 977: 973: 971: 967: 965: 961: 959: 955: 953: 949: 947: 943: 939: 935: 933: 929: 927: 923: 921: 917: 915: 911: 909: 905: 903: 899: 886: 880: 868:quality of life 861:pelvic fracture 853:ruptured spleen 829: 800: 771:Tranexamic acid 768: 706: 656:of the person. 644: 597:cervical collar 575: 542: 518:benzodiazepines 505: 499: 467: 415: 386: 373:, and proximal 344: 328:gluconeogenesis 271: 269:Pathophysiology 215: 144: 120:stabbing wounds 38: 35: 32: 23: 22: 15: 12: 11: 5: 6229: 6227: 6219: 6218: 6213: 6208: 6203: 6198: 6193: 6183: 6182: 6178: 6177: 6154: 6153: 6151: 6150: 6138: 6125: 6122: 6121: 6119: 6118: 6113: 6107: 6105: 6101: 6100: 6098: 6097: 6091: 6085: 6079: 6073: 6067: 6061: 6055: 6049: 6043: 6038: 6032: 6026: 6024: 6014: 6013: 6011: 6010: 6005: 6000: 5995: 5990: 5985: 5980: 5975: 5964: 5962: 5956: 5955: 5953: 5952: 5947: 5942: 5937: 5932: 5927: 5922: 5917: 5911: 5909: 5905: 5904: 5902: 5901: 5896: 5890: 5884: 5879: 5877:Laryngeal tube 5874: 5869: 5863: 5857: 5851: 5845: 5839:Defibrillation 5836: 5831: 5828:Bag valve mask 5824: 5822: 5816: 5815: 5813: 5812: 5807: 5802: 5797: 5792: 5787: 5782: 5777: 5772: 5767: 5762: 5757: 5751: 5749: 5745: 5744: 5739: 5737: 5736: 5729: 5722: 5714: 5705: 5704: 5702: 5701: 5696: 5691: 5686: 5680: 5678: 5674: 5673: 5671: 5670: 5665: 5660: 5655: 5642: 5637: 5628: 5619: 5614: 5609: 5603: 5601: 5597: 5596: 5594: 5593: 5588: 5583: 5578: 5572: 5570: 5564: 5563: 5561: 5560: 5559: 5558: 5553: 5548: 5543: 5538: 5533: 5528: 5513: 5511: 5505: 5504: 5502: 5501: 5496: 5491: 5486: 5481: 5476: 5471: 5465: 5463: 5457: 5456: 5454: 5453: 5452: 5451: 5440: 5438: 5434: 5433: 5423: 5421: 5420: 5413: 5406: 5398: 5389: 5388: 5386: 5385: 5380: 5375: 5370: 5369: 5368: 5363: 5353: 5352: 5351: 5349:Rhabdomyolysis 5344:Crush syndrome 5341: 5340: 5339: 5329: 5324: 5319: 5313: 5311: 5307: 5306: 5303: 5302: 5300: 5299: 5294: 5288: 5286: 5282: 5281: 5279: 5278: 5273: 5268: 5263: 5258: 5252: 5250: 5246: 5245: 5243: 5242: 5237: 5232: 5227: 5222: 5217: 5212: 5207: 5201: 5199: 5195: 5194: 5192: 5191: 5190: 5189: 5184: 5179: 5171: 5170: 5169: 5167:Splenic injury 5164: 5156: 5155: 5154: 5149: 5144: 5136: 5135: 5134: 5129: 5124: 5119: 5114: 5106: 5105: 5104: 5099: 5094: 5089: 5080: 5078: 5069: 5065: 5064: 5061: 5060: 5058: 5057: 5051: 5049: 5045: 5044: 5042: 5041: 5036: 5034:Trauma surgery 5031: 5026: 5021: 5016: 5010: 5008: 5001: 4997: 4996: 4993: 4992: 4990: 4989: 4984: 4978: 4976: 4975:Investigations 4972: 4971: 4969: 4968: 4963: 4958: 4953: 4947: 4945: 4936: 4932: 4931: 4929: 4928: 4923: 4918: 4913: 4908: 4903: 4897: 4895: 4891: 4890: 4885: 4883: 4882: 4875: 4868: 4860: 4851: 4850: 4840: 4839: 4836: 4835: 4823: 4822: 4820: 4816: 4815: 4812: 4811: 4800: 4789: 4770: 4754: 4749: 4748: 4746: 4745:Classification 4738: 4737:External links 4735: 4734: 4733: 4711: 4683: 4680: 4679: 4678: 4673:978-0781726412 4672: 4659: 4654:978-0071663519 4653: 4640: 4635:978-0340928264 4634: 4619: 4616: 4613: 4612: 4561: 4542:(4): 1226–33. 4526: 4475: 4469:978-0130845849 4468: 4450: 4416: 4373: 4354:(5): 482–8–8. 4336: 4308: 4302:978-0135005248 4301: 4293:Emergency Care 4283: 4238: 4185: 4169:"Injury Facts" 4160: 4123: 4072: 4066:978-0323065023 4065: 4048: 4005: 3950: 3938: 3892: 3886:978-0199543328 3885: 3862: 3808: 3780: 3727: 3709: 3703:978-0781762755 3702: 3677: 3650:(2): 195–201. 3634: 3599: 3590: 3584:978-1444109627 3583: 3561: 3555:978-0781726412 3554: 3536: 3525:. Apr 19, 2011 3507: 3458: 3413: 3394:(3): 489–500. 3377: 3350:(6): 1575–86. 3334: 3277: 3242: 3188: 3135: 3124:"UpToDate Inc" 3112: 3087: 3044: 3025:(6): 1403–23. 3006: 3000:978-0071484800 2999: 2978: 2934: 2886: 2883:on 2012-01-18. 2840: 2787: 2743: 2734: 2699: 2690: 2681: 2669: 2657: 2622: 2581: 2538: 2509:(9): 1141–52. 2489: 2462:(3): 295–302. 2442: 2407: 2398: 2355: 2305: 2248: 2223: 2209: 2203:978-0313296864 2202: 2178: 2140: 2105: 2070: 2035: 2000: 1949: 1906: 1868: 1859: 1853:978-1880696316 1852: 1824: 1805:(6): 691–709. 1787: 1778: 1769: 1760: 1754:978-0781748025 1753: 1732: 1705: 1699:978-0340947647 1698: 1680: 1637: 1631:978-0781732000 1630: 1612: 1606:978-0340928264 1605: 1587: 1581:978-0135005231 1580: 1572:Emergency Care 1562: 1556:978-0071496797 1555: 1537: 1528: 1499:(8): 1341–61. 1479: 1453: 1444: 1386: 1364: 1358:978-0323054720 1357: 1328: 1319: 1278: 1252: 1251: 1249: 1246: 1229: 1226: 1187:pre-term labor 1178: 1175: 1171:Theron formula 1150: 1149: 1144: 1138: 1137: 1132: 1126: 1125: 1120: 1114: 1113: 1108: 1102: 1101: 1096: 1090: 1089: 1086: 1076:Main article: 1073: 1070: 1068: 1065: 1047: 1044: 1026: 1023: 1021: 1018: 1005: 1002: 980: 979: 976: > 275 972: 966: 960: 954: 948: 942: 940: 934: 928: 922: 916: 910: 904: 898: 893: 879: 876: 828: 825: 799: 796: 791:norepinephrine 767: 764: 705: 702: 679:cardiac arrest 643: 640: 574: 571: 541: 538: 501:Main article: 498: 495: 493:is indicated. 466: 463: 414: 411: 385: 382: 343: 340: 308: 307: 304: 302:cardiac output 298: 292: 287: 284: 270: 267: 229:, followed by 214: 211: 143: 142:Classification 140: 124:gunshot wounds 83: 82: 80:trauma surgery 73: 67: 66: 54: 53: 45: 44: 36: 33: 24: 18:Medical trauma 14: 13: 10: 9: 6: 4: 3: 2: 6228: 6217: 6214: 6212: 6209: 6207: 6204: 6202: 6199: 6197: 6194: 6192: 6189: 6188: 6186: 6176: 6166: 6162: 6149: 6148: 6139: 6137: 6136: 6127: 6126: 6123: 6117: 6114: 6112: 6109: 6108: 6106: 6102: 6095: 6092: 6089: 6086: 6083: 6080: 6077: 6074: 6071: 6068: 6065: 6062: 6059: 6056: 6053: 6050: 6047: 6044: 6042: 6039: 6036: 6033: 6031: 6028: 6027: 6025: 6023: 6019: 6015: 6009: 6006: 6004: 6001: 5999: 5996: 5994: 5991: 5989: 5986: 5984: 5981: 5979: 5976: 5973: 5969: 5966: 5965: 5963: 5961: 5960:Organisations 5957: 5951: 5948: 5946: 5943: 5941: 5938: 5936: 5933: 5931: 5928: 5926: 5923: 5921: 5918: 5916: 5913: 5912: 5910: 5906: 5900: 5897: 5894: 5891: 5888: 5885: 5883: 5880: 5878: 5875: 5873: 5870: 5867: 5864: 5861: 5858: 5855: 5852: 5849: 5846: 5844: 5840: 5837: 5835: 5832: 5829: 5826: 5825: 5823: 5821: 5817: 5811: 5808: 5806: 5805:Trauma center 5803: 5801: 5798: 5796: 5793: 5791: 5788: 5786: 5783: 5781: 5778: 5776: 5773: 5771: 5768: 5766: 5763: 5761: 5758: 5756: 5753: 5752: 5750: 5746: 5742: 5735: 5730: 5728: 5723: 5721: 5716: 5715: 5712: 5700: 5697: 5695: 5692: 5690: 5687: 5685: 5682: 5681: 5679: 5675: 5669: 5666: 5664: 5661: 5659: 5656: 5654: 5653:Chemical burn 5650: 5646: 5643: 5641: 5638: 5636: 5632: 5629: 5627: 5624:/superficial/ 5623: 5620: 5618: 5615: 5613: 5610: 5608: 5605: 5604: 5602: 5598: 5592: 5589: 5587: 5584: 5582: 5579: 5577: 5574: 5573: 5571: 5569: 5565: 5557: 5554: 5552: 5549: 5547: 5546:Cullen's sign 5544: 5542: 5539: 5537: 5534: 5532: 5529: 5527: 5526:Battle's sign 5524: 5523: 5522: 5518: 5515: 5514: 5512: 5510: 5506: 5500: 5497: 5495: 5492: 5490: 5487: 5485: 5484:Edema blister 5482: 5480: 5477: 5475: 5472: 5470: 5469:Blood blister 5467: 5466: 5464: 5462: 5458: 5450: 5447: 5446: 5445: 5442: 5441: 5439: 5435: 5431: 5427: 5419: 5414: 5412: 5407: 5405: 5400: 5399: 5396: 5384: 5383:Wound healing 5381: 5379: 5376: 5374: 5371: 5367: 5364: 5362: 5359: 5358: 5357: 5354: 5350: 5347: 5346: 5345: 5342: 5338: 5335: 5334: 5333: 5330: 5328: 5325: 5323: 5320: 5318: 5315: 5314: 5312: 5310:Complications 5308: 5298: 5295: 5293: 5290: 5289: 5287: 5283: 5277: 5274: 5272: 5269: 5267: 5266:Facial trauma 5264: 5262: 5259: 5257: 5254: 5253: 5251: 5247: 5241: 5238: 5236: 5233: 5231: 5230:Gunshot wound 5228: 5226: 5225:Electrocution 5223: 5221: 5218: 5216: 5213: 5211: 5208: 5206: 5203: 5202: 5200: 5196: 5188: 5185: 5183: 5180: 5178: 5175: 5174: 5172: 5168: 5165: 5163: 5160: 5159: 5157: 5153: 5150: 5148: 5145: 5143: 5140: 5139: 5137: 5133: 5130: 5128: 5125: 5123: 5120: 5118: 5115: 5113: 5110: 5109: 5107: 5103: 5100: 5098: 5095: 5093: 5090: 5088: 5087:Bone fracture 5085: 5084: 5082: 5081: 5079: 5077: 5073: 5070: 5066: 5056: 5053: 5052: 5050: 5046: 5040: 5037: 5035: 5032: 5030: 5029:Trauma center 5027: 5025: 5022: 5020: 5017: 5015: 5012: 5011: 5009: 5005: 5002: 4998: 4988: 4985: 4983: 4980: 4979: 4977: 4973: 4967: 4964: 4962: 4959: 4957: 4954: 4952: 4949: 4948: 4946: 4944: 4940: 4937: 4933: 4927: 4924: 4922: 4921:Resuscitation 4919: 4917: 4914: 4912: 4909: 4907: 4904: 4902: 4899: 4898: 4896: 4892: 4888: 4881: 4876: 4874: 4869: 4867: 4862: 4861: 4858: 4854: 4848: 4845: 4844: 4834: 4830: 4829: 4825: 4824: 4821: 4817: 4810: 4806: 4805: 4801: 4799: 4795: 4794: 4790: 4788: 4784: 4780: 4779: 4775: 4771: 4769: 4765: 4764: 4760: 4756: 4755: 4752: 4747: 4743: 4736: 4724:on 2011-06-22 4723: 4719: 4718: 4712: 4702:on 2011-06-23 4701: 4697: 4693: 4692: 4686: 4685: 4681: 4675: 4669: 4665: 4660: 4656: 4650: 4646: 4641: 4637: 4631: 4627: 4622: 4621: 4617: 4608: 4604: 4599: 4594: 4590: 4586: 4583:(8): 531–64. 4582: 4578: 4577: 4572: 4565: 4562: 4557: 4553: 4549: 4545: 4541: 4537: 4530: 4527: 4522: 4518: 4513: 4508: 4504: 4500: 4496: 4492: 4491: 4486: 4479: 4476: 4471: 4465: 4461: 4454: 4451: 4446: 4442: 4438: 4431: 4429: 4427: 4425: 4423: 4421: 4417: 4412: 4408: 4404: 4400: 4396: 4392: 4388: 4384: 4377: 4374: 4369: 4365: 4361: 4357: 4353: 4349: 4348: 4340: 4337: 4326: 4322: 4318: 4312: 4309: 4304: 4298: 4294: 4287: 4284: 4279: 4275: 4271: 4267: 4263: 4259: 4255: 4251: 4250: 4242: 4239: 4234: 4230: 4225: 4220: 4215: 4210: 4206: 4202: 4201: 4196: 4189: 4186: 4170: 4164: 4161: 4156: 4152: 4148: 4144: 4140: 4136: 4135: 4127: 4124: 4119: 4115: 4110: 4105: 4101: 4097: 4094:(2): 307–16. 4093: 4089: 4088: 4083: 4076: 4073: 4068: 4062: 4058: 4052: 4049: 4044: 4040: 4036: 4032: 4028: 4024: 4020: 4016: 4009: 4006: 4001: 3997: 3993: 3989: 3985: 3981: 3977: 3973: 3969: 3965: 3961: 3954: 3951: 3945: 3943: 3939: 3934: 3930: 3925: 3920: 3916: 3912: 3911: 3906: 3899: 3897: 3893: 3888: 3882: 3878: 3871: 3869: 3867: 3863: 3858: 3854: 3850: 3846: 3841: 3836: 3833:(7): 697–98. 3832: 3828: 3824: 3817: 3815: 3813: 3809: 3797: 3790: 3784: 3781: 3776: 3772: 3768: 3764: 3759: 3754: 3750: 3746: 3742: 3738: 3731: 3728: 3723: 3719: 3713: 3710: 3705: 3699: 3695: 3688: 3686: 3684: 3682: 3678: 3673: 3669: 3665: 3661: 3657: 3653: 3649: 3645: 3638: 3635: 3630: 3626: 3622: 3618: 3614: 3610: 3603: 3600: 3594: 3591: 3586: 3580: 3576: 3572: 3565: 3562: 3557: 3551: 3547: 3540: 3537: 3524: 3517: 3511: 3508: 3503: 3499: 3495: 3491: 3486: 3481: 3478:(5): 342–51. 3477: 3473: 3469: 3462: 3459: 3454: 3450: 3445: 3440: 3436: 3432: 3428: 3424: 3417: 3414: 3409: 3405: 3401: 3397: 3393: 3389: 3381: 3378: 3373: 3369: 3365: 3361: 3357: 3353: 3349: 3345: 3338: 3335: 3330: 3326: 3321: 3316: 3312: 3308: 3304: 3300: 3296: 3292: 3288: 3281: 3278: 3273: 3269: 3265: 3261: 3257: 3253: 3246: 3243: 3238: 3234: 3230: 3226: 3221: 3216: 3212: 3208: 3204: 3200: 3192: 3189: 3184: 3178: 3170: 3166: 3162: 3158: 3154: 3150: 3146: 3139: 3136: 3125: 3119: 3117: 3113: 3101: 3097: 3091: 3088: 3083: 3079: 3075: 3071: 3067: 3063: 3060:(2): 246–50. 3059: 3055: 3048: 3045: 3040: 3036: 3032: 3028: 3024: 3020: 3013: 3011: 3007: 3002: 2996: 2992: 2985: 2983: 2979: 2974: 2970: 2966: 2962: 2958: 2954: 2951:(4): 954–61. 2950: 2946: 2938: 2935: 2930: 2926: 2922: 2918: 2914: 2910: 2907:(4): 283–88. 2906: 2902: 2895: 2893: 2891: 2887: 2882: 2878: 2874: 2870: 2866: 2862: 2855: 2853: 2851: 2849: 2847: 2845: 2841: 2836: 2832: 2827: 2822: 2817: 2812: 2808: 2804: 2803: 2798: 2791: 2788: 2783: 2779: 2774: 2769: 2765: 2761: 2757: 2750: 2748: 2744: 2738: 2735: 2730: 2726: 2722: 2718: 2714: 2710: 2703: 2700: 2694: 2691: 2685: 2682: 2679: 2673: 2670: 2667: 2661: 2658: 2653: 2649: 2645: 2641: 2637: 2633: 2626: 2623: 2618: 2614: 2609: 2604: 2600: 2596: 2592: 2585: 2582: 2577: 2573: 2569: 2565: 2561: 2557: 2554:(6): 691–96. 2553: 2549: 2542: 2539: 2534: 2530: 2525: 2520: 2516: 2512: 2508: 2504: 2500: 2493: 2490: 2485: 2481: 2477: 2473: 2469: 2465: 2461: 2457: 2453: 2446: 2443: 2438: 2434: 2430: 2426: 2422: 2418: 2411: 2408: 2402: 2399: 2394: 2390: 2385: 2380: 2377:(7): 617–21. 2376: 2372: 2371: 2366: 2359: 2356: 2351: 2347: 2343: 2339: 2334: 2329: 2325: 2321: 2317: 2309: 2306: 2301: 2297: 2292: 2287: 2283: 2279: 2275: 2271: 2268:(6): 531–40. 2267: 2263: 2259: 2252: 2249: 2238:on 2015-09-24 2237: 2233: 2227: 2224: 2219: 2213: 2210: 2205: 2199: 2195: 2191: 2190: 2182: 2179: 2174: 2170: 2166: 2162: 2158: 2154: 2147: 2145: 2141: 2136: 2132: 2128: 2124: 2120: 2116: 2109: 2106: 2101: 2097: 2093: 2089: 2086:(2): 278–84. 2085: 2081: 2074: 2071: 2066: 2062: 2058: 2054: 2050: 2046: 2039: 2036: 2031: 2027: 2023: 2019: 2016:(2): 314–22. 2015: 2011: 2004: 2001: 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