[Preoperative measures in emergencies].
OBJECTIVE
To define the minimally necessary preoperative evaluation and preparation of an emergency patient of a surgical ward.


CONCLUSIONS
While the preoperative evaluation and preparation of a patient for elective surgery aiming at minimizing any risk may take some time, the emergency patient has to be managed intensively and rapidly in order to save life, limb or organ function. Resuscitation of vital functions is best done in collaboration with the anaesthesists and ICU team and has absolute priority. Following this careful clinical examination and the personal history--if obtainable--are more important for decision making than most laboratory data or technical investigations. However, any informations on coagulopathy and metabolic disorders appear essential, as they should be corrected before surgery. Ultrasound is today the most important technical tool to evaluate the abdominal and thoracic cavity, while x-rays are essential for the detection and documentation of any skeletal lesions. CT-scan is indispensable for the examination of the central nervous system. All findings must be carefully recorded allowing for the scoring of any injury or illness which appears important for prognostic considerations as well as for follow-up and quality control.


CONCLUSIONS
The management of any emergency case is demanding and needs experienced physicians. A schematic procedure adapted to the local possibilities and facilities is helpful for an effective and often life-saving team work between the resuscitation team and surgeons.
Leutenegger
A
A
Chirurgische Klinik, Rätisches Kantons- und Regionalspital Chur.
D003955:Diagnostic Tests, Routine; D004630:Emergencies; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology / Q000517:prevention & control*; D016343:Monitoring, Intraoperative; D010348:Patient Care Team; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods*; D011379:Prognosis; D012151:Resuscitation; D018570:Risk Assessment; D013557:Switzerland