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There currently is a clear tendency to an increasing number of accidental injuries in elderly people, in sport injuries and car crashes also in countries which recently joined the European Union and candidates to join the European Union. Patients expect very good functional results even after serious injuries. But in contrast to this development, Trauma Surgery as an independent field, is not yet established in all European countries. Therefore, it seems mandatory to compile a book that covers the state-of-the-art in Trauma Surgery. The book also serves to harmonise the practice of Trauma Surgery within the European Union, and to prepare for the exam of the U.E.M.S.
Advances in trauma care have accelerated over the past decade, spurred by the significant burden of injury from the wars in Afghanistan and Iraq. Between 2005 and 2013, the case fatality rate for United States service members injured in Afghanistan decreased by nearly 50 percent, despite an increase in the severity of injury among U.S. troops during the same period of time. But as the war in Afghanistan ends, knowledge and advances in trauma care developed by the Department of Defense (DoD) over the past decade from experiences in Afghanistan and Iraq may be lost. This would have implications for the quality of trauma care both within the DoD and in the civilian setting, where adoption of military advances in trauma care has become increasingly common and necessary to improve the response to multiple civilian casualty events. Intentional steps to codify and harvest the lessons learned within the military's trauma system are needed to ensure a ready military medical force for future combat and to prevent death from survivable injuries in both military and civilian systems. This will require partnership across military and civilian sectors and a sustained commitment from trauma system leaders at all levels to assure that the necessary knowledge and tools are not lost. A National Trauma Care System defines the components of a learning health system necessary to enable continued improvement in trauma care in both the civilian and the military sectors. This report provides recommendations to ensure that lessons learned over the past decade from the military's experiences in Afghanistan and Iraq are sustained and built upon for future combat operations and translated into the U.S. civilian system.
Injuries are the leading cause of death and disability among people under age 35 in the United States. Despite great strides in injury prevention over the decades, injuries result in 150,000 deaths, 2.6 million hospitalizations, and 36 million visits to the emergency room each year. Reducing the Burden of Injury describes the cost and magnitude of the injury problem in America and looks critically at the current response by the public and private sectors, including: Data and surveillance needs. Research priorities. Trauma care systems development. Infrastructure support, including training for injury professionals. Firearm safety. Coordination among federal agencies. The authors define the field of injury and establish boundaries for the field regarding intentional injuries. This book highlights the crosscutting nature of the injury field, identifies opportunities to leverage resources and expertise of the numerous parties involved, and discusses issues regarding leadership at the federal level.
This book provides a systemic approach to acute trauma care in line with the ABCDE paradigm and up-to-date information on assessing and managing major trauma from the pre-hospital to the rehabilitation phase. The book's early sections are dedicated to identifying and managing pathology caused by massive haemorrhage, airway, breathing, circulation or neurological trauma and examining the current evidence base relating to their management. The book then builds from fundamental skills to advanced interventions so that each level of responder can identify and implement aspects of clinical practice that will be of benefit to them at their stage. This approach also explains advanced interventions that may be executed subsequently, explaining how each phase of care sits together. This has a further benefit of producing seamless care for patients by practitioners of different levels using this book as a reference point. Later sections deal with specifics of in-hospital trauma care by speciality, including the explanation of decision making processes by specialities, use of diagnostic and interventional radiology, rehabilitation and psychological aspects of trauma care. The Textbook of Acute Trauma Care also focuses on non-clinical issues relevant to trauma such as training and logistics of retrieval and repatriation, aviation considerations in HEMS, legal and forensic evidence considerations and ethical issues dealing with trauma patients. In addition, the book contains chapters from international experts on cognitive and human factors relating to healthcare and suggests strategies for training and minimising errors. This book is an essential resource for all grades of practitioner, from first responders to Consultant/Attending Physician level providers.
This book offers an overview of acute care surgery around the world, focusing on the four main branches of this novel subdiscipline: trauma, general emergencies, critical care, and rescue surgery. The book’s primary goal is to provide a general view of acute care surgery, while addressing the most important issues in depth. The content is divided into three parts, the first of which is dedicated to the general organization of trauma centers, including the composition of modern trauma teams. Protocols of activation and action for the trauma team, as well as damage control procedures both in the emergency room and in the surgical theatre, are described. The book also addresses the development of a trauma registry, together with the quality assessment process that can be applied. In turn, the second part describes the principal protocols for making diagnoses, with special attention to circumstances such as unstable hemodynamics, neurological deterioration, normal vital signs, and penetrating injuries. The book subsequently deals with the most important aspects of trauma to the abdomen, chest, and pelvis, with notes on both surgical and intensive care issues. Practical descriptions of how to treat principal injuries to various organs are also provided. Finally, the third part of the book is dedicated to the most frequent general surgical emergencies and rescue surgical approaches, and includes information on diagnostic support with point of care ultrasound and endoscopic advanced techniques. Presenting cutting-edge strategies, this book will be of interest to professionals involved in surgical and intensive care for emergency conditions, such as colonic perforations, obstructions, acute pancreatitis, biliary tree stones, and caustic injuries.
This evidence-based manual highlights the early management of acutely injured trauma victims arriving in emergency triage areas. It caters to the needs of developing nations in pre-hospital as well as in-hospital emergency trauma care and provides clear practical guidelines for the management of victims of major trauma. The book covers basic principles for managing a crashing trauma patient, followed by effective treatment by different sub-specialty. Input from experienced anaesthesiologists, intensivists, orthopaedics, vascular surgeons, plastic surgeons, and radiologists, make this book a gold standard for good practice for professionals. Key Features: Covers all aspects of acute trauma, including orthopaedics, vascular surgery, plastic surgery, neurosurgery, burns and radiology Elaborates on damage control resuscitation and management of initial and life-threatening injuries, useful for professionals dealing with trauma patients in the emergency area Guides in initial fluid therapy and pain control along with initial patient resuscitation
Essential Surgery is part of a nine volume series for Disease Control Priorities which focuses on health interventions intended to reduce morbidity and mortality. The Essential Surgery volume focuses on four key aspects including global financial responsibility, emergency procedures, essential services organization and cost analysis.
The Trauma Care Manual was first published in 2000, and was the first evidence-based manual of best trauma practice. Now in its second edition, it continues to offer clear and practical guidelines for the management of victims of major trauma, reflecting current practice in the United Kingdom and Europe.The second edition benefits from an increase
Interpersonal trauma is ubiquitous and its impact on health has long been understood. Recently, however, the critical importance of this issue has been magnified in the public eye. A burgeoning literature has demonstrated the impact of traumatic experiences on mental and physical health, and many potential interventions have been proposed. This volume serves as a detailed, practical guide to trauma-informed care. Chapters provide guidance to both healthcare providers and organizations on strategies for adopting, implementing and sustaining principles of trauma-informed care. The first section maps out the scope of the problem and defines specific types of interpersonal trauma. The authors then turn to discussion of adaptations to care for special populations, including sexual and gender minority persons, immigrants, male survivors and Veterans as these groups often require more nuanced approaches. Caring for trauma-exposed patients can place a strain on clinicians, and approaches for fostering resilience and promoting wellness among staff are presented next. Finally, the book covers concrete trauma-informed clinical strategies in adult and pediatric primary care, and women’s health/maternity care settings. Using a case-based approach, the expert authors provide real-world front line examples of the impact trauma-informed clinical approaches have on patients’ quality of life, sense of comfort, and trust. Case examples are discussed along with evidence based approaches that demonstrate improved health outcomes. Written by experts in the field, Trauma-Informed Healthcare Approaches is the definitive resource for improving quality care for patients who have experienced trauma.
The first edition of this publication was aimed at defining the current concepts of trauma induced coagulopathy by critically analyzing the most up-to-date studies from a clinical and basic science perspective. It served as a reference source for any clinician interested in reviewing the pathophysiology, diagnosis, and management of the coagulopathic trauma patient, and the data that supports it. By meticulously describing the methodology of most traditional as well as state of the art coagulation assays the reader is provided with a full understanding of the tests that are used to study trauma induced coagulopathy. With the growing interest in understanding and managing coagulation in trauma, this second edition has been expanded to 46 chapters from its original 35 to incorporate the massive global efforts in understanding, diagnosing, and treating trauma induced coagulopathy. The evolving use of blood products as well as recently introduced hemostatic medications is reviewed in detail. The text provides therapeutic strategies to treat specific coagulation abnormalities following severe injury, which goes beyond the first edition that largely was based on describing the mechanisms causing coagulation abnormalities. Trauma Induced Coagulopathy 2nd Edition is a valuable reference to clinicians that are faced with specific clinical challenges when managing coagulopathy.