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Emergency Medicine


Answer 1
  1. Maintain serum glucose < 200 mg/dL. Stress from a traumatic event results in hyperglycemia. According to Bochicchio et al,1 abdominal surgery patients who were hyperglycemic on postoperative day 1 had an infection rate 2.7 times greater than those who were normoglycemic. Tight glucose control is recommended in critically ill patients. Empiric use of broad- spectrum antibiotics in trauma patients is not indicated. In a patient who is oxygenating well, intubation is unnecessary. Placement of a drainage catheter is not standard of care in liver lacerations. Intensive care unit admissions are associated with increased morbidity due to the risks of nosocomial infections.

    REFERENCES
    1. Bochicchio GV, Salzano L, Joshi M, et al. Admission preoperative glucose is predictive of morbidity and mortality in trauma patients who require immediate operative intervention. Am Surg 2005;17:171-4.

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