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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.
The two-volume Emergency Medical Services: Clinical Practice and Systems Oversight delivers a thorough foundation upon which to succeed as an EMS medical director and prepare for the NAEMSP National EMS Medical Directors Course and Practicum. Focusing on EMS in the 'real world', the book offers specific management tools that will be useful in the reader's own local EMS system and provides contextual understanding of how EMS functions within the broader emergency care system at a state, local, and national level. The two volumes offer the core knowledge trainees will need to successfully complete their training and begin their career as EMS physicians, regardless of the EMS systems in use in their areas. A companion website rounds out the book's offerings with audio and video clips of EMS best practice in action. Readers will also benefit from the inclusion of: A thorough introduction to the history of EMS An exploration of EMS airway management, including procedures and challenges, as well as how to manage ventilation, oxygenation, and breathing in patients, including cases of respiratory distress Practical discussions of medical problems, including the challenges posed by the undifferentiated patient, altered mental status, cardiac arrest and dysrhythmias, seizures, stroke, and allergic reactions An examination of EMS systems, structure, and leadership
Today our emergency care system faces an epidemic of crowded emergency departments, patients boarding in hallways waiting to be admitted, and daily ambulance diversions. Hospital-Based Emergency Care addresses the difficulty of balancing the roles of hospital-based emergency and trauma care, not simply urgent and lifesaving care, but also safety net care for uninsured patients, public health surveillance, disaster preparation, and adjunct care in the face of increasing patient volume and limited resources. This new book considers the multiple aspects to the emergency care system in the United States by exploring its strengths, limitations, and future challenges. The wide range of issues covered includes: • The role and impact of the emergency department within the larger hospital and health care system. • Patient flow and information technology. • Workforce issues across multiple disciplines. • Patient safety and the quality and efficiency of emergency care services. • Basic, clinical, and health services research relevant to emergency care. • Special challenges of emergency care in rural settings. Hospital-Based Emergency Care is one of three books in the Future of Emergency Care series. This book will be of particular interest to emergency care providers, professional organizations, and policy makers looking to address the deficiencies in emergency care systems.
This encyclopedia is an authoritative compilation of practical information on major topics in trauma management. Its encyclopedic format will allow the reader to rapidly find up-to-date information on a specific topic of interest. The book is organized in an organ-based manner for ease of use when a practitioner is confronted with a particular injury. Each chapter takes the form of a clearly structured review of the subject in question and includes informative illustrations and tables as well as lists of classic references. In addition to the full range of organ-specific injuries, a number of important further topics are covered, including critical care of the trauma patient, trauma system organization, mass injury scenarios, the impact of new technologies, complications in trauma care, and ethical issues. All of the authors are leading experts, and the encyclopedia will provide an excellent source of information for both basic and clinical scientists and trainees in various fields.
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.
"For too many traumatized children and their families, chronic stressors such as poverty, substance abuse, and family or community violence--coupled with an overburdened care system/m-/pose seemingly insurmountable barriers to treatment. This empowering book provides a user-friendly blueprint for making the most of limited resources to help those considered the "toughest cases." Evidence-based strategies are presented for effectively integrating individualized treatment with services at the home, school, and community levels. Written in an accessible, modular format with reproducible forms and step-by-step guidelines for assessment and intervention, the approach is grounded in the latest knowledge about child traumatic stress. It has been recognized as a treatment of choice by state mental health agencies nationwide"--