PERSPECTIVES

perspective

THE QUIET ROOM

At the end of an inconspicuous hallway and strategically placed far from the controlled chaos of the trauma room lies a dimly lit waiting area that we in the medical field call “the quiet room.” It is a bland spot; a few soft chairs surround a table that holds a box of crisp institutional tissues. There may be a picture or two on the wall, but generally it is an unassuming room where we physicians tell mothers about the deaths of their children, far too often because of firearm violence.

perspective

PATIENT-REPORTED OUTCOME MEASURES: A STETHOSCOPE FOR THE PATIENT HISTORY

John Doe stands in the burn clinic waiting room, accompanied by his visibly concerned wife. He is pacing, unable to tolerate the pins and needles in his burned legs that occurs whenever he stands still. Just 3 months ago, John worked 2 jobs to support his family of 5, and there was barely enough money to get by. The factory fire caused burns to half his body. His wife is grateful that he survived and that he is now home. However, life has changed dramatically for both of them. Now they are facing the realities of getting by each day.

JOURNALS

research article

Damage Control and the Open Abdomen: Challenges for the Nonsurgical Intensivist

As strategies in acute care surgery focus on damage control to restore physiology, intensivists spanning all disciplines care for an increasing number of patients requiring massive transfusion, temporary abdominal closures, and their sequelae.

research article

Sedation and Pain Management in Burn Patients

Abstract

Although pain management is a major challenge for clinicians, appropriate pain control is the foundation of efficacious burn care from initial injury to long-term recovery. The very treatments designed to treat burn wounds may inflict more pain than the initial injury itself, making it the clinician's duty to embrace a multimodal treatment approach to burn pain. Vigilant pain assessment, meaningful understanding of the pathophysiology and pharmacologic considerations across different phases of burn injury, and compassionate attention to anxiety and other psychosocial contributors to pain will enhance the clinician's ability to provide excellent pain management.