Newer Techniques in evaluation of injured patients.

Effective management of the severely injured requires an experienced, knowledgeable, and thoughtful physician who has a rational approach to both evaluation and treatment firmly in mind. When in doubt, access to a Trauma Registry (computerized) can be exceedingly valuable to assist in selecting the most effective treatment for a given clinical problem. The evaluation of the patient centers about general metabolic considerations, including acid-base disequilibrium, respiratory insufficiency, fluid volume monitoring, tissue perfusion (urine output), and osmolality. Diagnostic efforts to identify organ injury include infusion pyelography, paracentesis, radionuclide scanning, and angiography. The most critical diagnostic evaluation, however, remains frequent, careful examination of the injured patient, meticulously noting and interpreting all changes in physical findings.