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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.
Historically, 20% of all injured combatants die on the battlefield before they can be evacuated to a field hospital. Blood lossâ€"hemorrhageâ€"is the single major cause of death among those killed in action whose lives might otherwise be saved. Fluid resuscitation and the treatment of hypovolemia (the abnormally decreased volume of circulating fluid in the body) offer the greatest opportunity for reducing mortality and morbidity associated with battlefield casualties. In Fluid Resuscitation, a committee of experts assess current resuscitation fluids and protocols for the treatment of combat casualties and make recommendations for future research. Chapters focus on the pathophysiology of acute hemorrhagic shock, experience with and complications of fluid resuscitation, novel approaches to the treatment of shock, protocols of care at the site of injury, and future directions for research. The committee explicitly describes the similarities and differences between acute medical care during combat and civilian emergency trauma care. Fluid Resuscitation should help energize and focus research in both civilian and military emergency care and help save the lives of citizens and soldiers alike.
This presentation describes various aspects of the regulation of tissue oxygenation, including the roles of the circulatory system, respiratory system, and blood, the carrier of oxygen within these components of the cardiorespiratory system. The respiratory system takes oxygen from the atmosphere and transports it by diffusion from the air in the alveoli to the blood flowing through the pulmonary capillaries. The cardiovascular system then moves the oxygenated blood from the heart to the microcirculation of the various organs by convection, where oxygen is released from hemoglobin in the red blood cells and moves to the parenchymal cells of each tissue by diffusion. Oxygen that has diffused into cells is then utilized in the mitochondria to produce adenosine triphosphate (ATP), the energy currency of all cells. The mitochondria are able to produce ATP until the oxygen tension or PO2 on the cell surface falls to a critical level of about 4–5 mm Hg. Thus, in order to meet the energetic needs of cells, it is important to maintain a continuous supply of oxygen to the mitochondria at or above the critical PO2 . In order to accomplish this desired outcome, the cardiorespiratory system, including the blood, must be capable of regulation to ensure survival of all tissues under a wide range of circumstances. The purpose of this presentation is to provide basic information about the operation and regulation of the cardiovascular and respiratory systems, as well as the properties of the blood and parenchymal cells, so that a fundamental understanding of the regulation of tissue oxygenation is achieved.
Close monitoring of patients during anesthesia is crucial for ensuring positive treatment outcomes and patient safety. The increasing availability of new technologies and the repurposing of older monitors means more patient data is at anesthesiologists' fingertips than ever before. However, this flood of options can be overwhelming. A practical resource for understanding this array of clinical monitoring options in anesthesia, this important text focuses on real-world applications in anesthesia and perioperative care. Reviewing the evidence for improved patient outcomes for monitoring technology, neurological monitoring, echocardiography systems and ultrasound are amongst the techniques covered in a head-to-toe approach. Statistics used by manufacturers to gain approval for their technology are discussed, as well as the under-appreciated risks associated with monitoring such as digital distraction. Future monitoring technologies including wearable systems are explored in depth. Focusing on applied practice, this book is an essential text for front-line healthcare professionals in anesthesia.
TUMESCENT TECHNIQUE is the definitive reference on all aspects of the tumescent technique of anesthesiology used in liposuction. Written by the inventor of the tumescent technique, this resource explains the pathophysiology, complications, pharmacology, and the different methods used to achieve great cosmetic results. Step-by-step instructions demonstrate how to perform this procedure on all areas of the body. Complications and postoperative care are also addressed. * Written by Dr. Klein, a leading expert in the field and the physician who invented and perfected the technique. * Provides step-by-step instructions for administering the local anesthesia with a practical, easy-to-follow approach. * Discusses tumescent liposuction techniques for each body region, addressing procedures, guidelines, and complications for each. * Covers complications and how to avoid them, preventing problems before they arise. * Provides detailed illustrations of techniques and before and after photographs to allow you to see expected results.
Diagnosis of PPH -- Management of atonic PPH -- Management of retained placenta -- Choice of fluid for replacement or resuscitation -- Health systems and organizational interventions -- PPH care pathways -- Research implications -- Plans for local adaptation of the recommendations -- Plans for supporting implementation of these recommendations -- GRADE tables.
This book provides a comprehensive overview of damage control resuscitation (DCR), an evidence-based approach to the resuscitation of patients with severe life-threatening hemorrhage (LTH). It focuses on both civilian and military applications as DCR is utilized in civilian trauma situations as well as combat casualty care settings. The book covers the history of fluid resuscitation for bleeding, epidemiology of severe traumatic injuries, prediction of life-threatening hemorrhage, pathophysiology and diagnosis of blood failure, and permissive hypotension. Chapters provide in-depth detail on hemostatic resuscitation principles, dried plasma, dried platelet surrogates, and recent developments in frozen red blood cells and oxygen carriers. The book also discusses how DCR principles can be used in a variety of situations such as when there are large numbers of patients with hemorrhagic lesions, non-trauma scenarios, and on distinct populations such as children. Finally, it concludes with a discussion of training and education methods for the implementation of DCR and remote DCR principles as well as learning healthcare system principles to facilitate the implementation of DCR and ultimately improve outcomes for patients with life-threatening hemorrhage. Damage Control Resuscitation: Identification and Treatment of Life-Threatening Hemorrhage is an essential resource for physicians and related professionals, residents, nurses and medical students in emergency medicine, anesthesia, surgery, and critical care, as well as civilian and military EMS providers.
The most practical and efficient guide to the diagnosis and management of blood disorders – now in full color 200 full-color illustrations! Hematology in Clinical Practice is a succinct, cutting-edge guide to the diagnosis and treatment of disorders of red blood cells, white blood cells, and hemostasis, and the use of blood components for transfusion. Each disease state is discussed in detail, incorporating the pathophysiology, clinical features, up-to-date laboratory testing, and current management strategies into a comprehensive and practical approach to hematologic disorders. Features: New full-color presentation includes over 200 superb illustrations and classic images of blood morphology, tissue pathology, and clinical findings New Case Histories introduce and continue through relevant chapters, highlighting critical clinical points for diagnosis and management New end-of-chapter Points to Remember encapsulate key clinical information New chapters include Anemia in the Elderly and expanded and updated coverage of Transplantation and treatment of hematologic malignancies Outstanding collection of tables, charts, and illustrations that translate basic science into valuable clinical context Strong focus on practical clinical management and supportive care Coverage of state-of-the-art drugs and chemotherapies and the latest advances in genetic testing and molecular pathways Conveniently organized into sections on Red Cells, White Cells, Hemostasis, and Transfusion Medicine
Fully-updated edition of this award-winning textbook, arranged by presenting complaints with full-color images throughout. For students, residents, and emergency physicians.
Colorectal Cancer Screening provides a complete overview of colorectal cancer screening, from epidemiology and molecular abnormalities, to the latest screening techniques such as stool DNA and FIT, Computerized Tomography (CT) Colonography, High Definition Colonoscopes and Narrow Band Imaging. As the text is devoted entirely to CRC screening, it features many facts, principles, guidelines and figures related to screening in an easy access format. This volume provides a complete guide to colorectal cancer screening which will be informative to the subspecialist as well as the primary care practitioner. It represents the only text that provides this up to date information about a subject that is continually changing. For the primary practitioner, information on the guidelines for screening as well as increasing patient participation is presentedd. For the subspecialist, information regarding the latest imaging techniques as well as flat adenomas and chromoendoscopy are covered. The section on the molecular changes in CRC will appeal to both groups. The text includes up to date information about colorectal screening that encompasses the entire spectrum of the topic and features photographs of polyps as well as diagrams of the morphology of polyps as well as photographs of CT colonography images. Algorithms are presented for all the suggested guidelines. Chapters are devoted to patient participation in screening and risk factors as well as new imaging technology. This useful volume explains the rationale behind screening for CRC. In addition, it covers the different screening options as well as the performance characteristics, when available in the literature, for each test. This volume will be used by the sub specialists who perform screening tests as well as primary care practitioners who refer patients to be screened for colorectal cancer.