Trauma patients must be reevaluated constantly to<br>ensure that new findings are not overlooked and<br>to discover any deterioration in previously noted<br>findings. <br><br>As initial life-threatening injuries are<br>managed, other equally life-threatening problems<br>and less severe injuries may become apparent, which<br>can significantly affect the ultimate prognosis of the<br>patient. A high index of suspicion facilitates early<br>diagnosis and management.<br>Continuous monitoring of vital signs, oxygen<br>saturation, and urinary output is essential. For adult<br>patients, maintenance of urinary output at 0.5 mL/kg/h<br>is desirable. In pediatric patients who are older than<br>1 year, an output of 1 mL/kg/h is typically adequate.<br>Periodic ABG analyses and end-tidal CO2 monitoring<br>are useful in some patients.<br>The relief of severe pain is an important part of<br>treatment for trauma patients. Many injuries, especially<br>musculoskeletal injuries, produce pain and anxiety<br>in conscious patients. Effective analgesia usually<br>requires the administration of opiates or anxiolytics<br>intravenously (intramuscular injections are to be<br>avoided). These agents are used judiciously and in small<br>doses to achieve the desired level of patient comfort<br>and relief of anxiety while avoiding respiratory status<br>or mental depression, and hemodynamic changes.
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