Читать книгу Emergency Management of the Hi-Tech Patient in Acute and Critical Care - Группа авторов - Страница 41

Surgical consultation is needed for surgical emergencies: intussusception, BBS, colocutaneous fistula, peritonitis, and necrotizing fasciitis. Immature tube dislodgement will require replacement by the team responsible for its initial placement, but the emergency department team can initially manage all mature tracts. Consultation is needed if there is significant trauma to the tract, the tube is improperly positioned on dye study, or the patient is unable to tolerate feeds following tube replacement. GJ and J‐tube replacements will typically need interventional radiology consultation. Stomal site bleeding, leakage, or infection may be initially managed by the emergency department and seen in subspecialty clinic for further care. Similarly, gastric outlet obstruction can first be treated with tube repositioning by the emergency department team, but if the obstruction does not resolve, surgical consultation is needed.