Acute Care Surgery in the Rural Setting

  • Dana Christian Lynge
  • Nicholas W. Morris
  • John G. Hunter


A 25-year-old pregnant patient is brought to the trauma bay after sustaining devastating injuries in a motor vehicle crash. The patient was intubated in the field. She is in the third trimester (34 weeks) and has what is thought to be a lethal closed head injury (Glasgow Coma Scale of 3). While in the trauma bay, she has a precipitous and sustained drop in blood pressure, refractory to body positioning and fluid resuscitation. Which of the following should emergency management do at this time?
  1. (A)

    Emergency cesarean section

  2. (B)

    Computed tomography evaluation of the abdomen

  3. (C)

    Initiation of pressors

  4. (D)

    Immediate transfer to a tertiary facility (20 miles)

  5. (E)

    Initiation of do not resuscitate order



Trauma Center General Surgeon Rural Setting Necrotizing Fasciitis Rural Hospital 
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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Dana Christian Lynge
    • 1
  • Nicholas W. Morris
    • 2
  • John G. Hunter
    • 3
  1. 1.Department of Surgery, University of WashingtonSeattle Veterans Affairs Medical CenterSeattleUSA
  2. 2.Department of General SurgeryPowell Valley Health Care and HospitalPowellUSA
  3. 3.Department of SurgeryOregon Health and Science UniversityPortlandUSA

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