Current Therapy of Trauma and Surgical Critical Care E-Book

Donald D. Trunkey

Description

Demanding surgical situations require expert advice from pioneers in the field as well as from those on the front lines of trauma care. Practical and evidence-based, Current Therapy of Trauma and Surgical Critical Care, 2nd Edition, draws on the experience of Drs. Juan A. Asensio and Donald D. Trunkey to offer a comprehensive, contemporary summary of the treatment and post-operative management of traumatic injuries. The concise format makes it ideally suited for everyday use, and new, full-color illustrations highlight the most important aspects of urgent surgical care, including ventilator management, damage control, noninvasive techniques, imaging, infection control, dealing with mass casualties, and treating injuries induced by chemical and biological agents.

• Prepare for the unexpected with practical, concise coverage of major surgical problems in trauma and critical care.
• Get expert and up-to-date guidance on ventilator management, damage control, noninvasive techniques, imaging, infection control, dealing with mass casualties, treating injuries induced by chemical and biological agents, and much more.
• Find the information you need quickly and easily through numerous illustrations, key points boxes, algorithms, and tables.

• Get up to date with current developments in the use of endovascular stents for thoracic aortic injuries; the diagnosis of peripheral vascular injuries; new interventional imaging techniques and new uses for ultrasound; and new ventilator techniques such as HFJV and APRV.
• Make the most of new antibiotics to improve control of surgical infection, learn to use new antifungal agents, and implement innovative therapies to combat both methicillin- and oxacillin-resistant organisms.
• Benefit from tremendous recent advances in the field (often as a result of experience gained by military and civilian surgeons), including the development of damage control.
• NEW! Expert Consult eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, and references from the book on a variety of devices.

Sujets

• Médecine
• Médecine d'urgence
• Medical
• Surgery

Informations

• Publié par: Elsevier
• Date de parution: 20 avril 2015
• Nombre de lectures: 0
• EAN13: 9780323169172
• Langue: English
• Poids de l'ouvrage: 13 Mo

Extrait

Current Therapy of Trauma and Surgical critical Care
Second Edition
Juan A. Asensio, MD, FACS, FCCM, FRCS, KM
Professor of Surgery, Chief, Division of Trauma Surgery and Surgical Critical Care, Director, Trauma Center and Trauma Program
Department of Surgery, Creighton University School of Medicine, Creighton University Medical Center, Omaha, Nebraska
Donald D. Trunkey, MD, FACS
Professor Emeritus, Department of Surgery, Division of Trauma, Oregon Health and Science University, Portland, Oregon
Table of Contents
Cover image
Title page
Copyright
Contributors
Foreword
Preface
If—
Trauma Systems
Development of Trauma Systems
Modern trauma system development
Are trauma systems effective?
What are the current problems?
Solutions
Trauma Center Organization and Verification
Trauma system and trauma center organization
Trauma performance improvement process
Trauma center verification
Injury Severity Scoring: Its Definition and Practical Application
Injury description and scoring: conceptual background
Testing a test: statistical measures of predictive accuracy and power
Measuring anatomic injury
Measuring physiologic injury
Measuring physiologic reserve and comorbidity risk
More powerful predictions: combining several types of information
Statistical considerations
Improved prediction in trauma scoring
Conclusions
Role of Alcohol and Other Drugs in Trauma
Epidemiology
Effects of alcohol and drugs on management and outcome
Alcohol and injury recidivism
Withdrawal syndromes: prophylaxis and treatment
Definition of alcohol and drug problems
Rationale for brief alcohol interventions in trauma centers
Summary
Role of Trauma Prevention in Reducing Interpersonal Violence
Understanding the problem
Impact of enhanced trauma commitment on patient outcomes
In-hospital prevention: shortcomings
Effectiveness of a violence prevention program
Culture of violence
Trauma Scoring
Anatomic scoring systems
Physiologic scoring systems
Risk-adjustment scoring systems
Scoring systems evaluation
Summary
Results of the Medical Strategy for Military Trauma in Colombia
Knowing the primary enemy
Knowing the secondary enemy
Strategic plan for medical care
Conclusions
Prehospital Trauma Care
Influence of Emergency Medical Services on Outcome at Trauma Center
Golden hour or golden opportunity?
Prehospital fluids
To bleed or not to bleed—should tourniquets be standard care?
Conclusion
Field Triage in the Military Arena
General principles of triage
Triage in the twenty-first century battle space
Military triage decision making
Conclusion
Field Triage in the Civilian Arena
History and evolution of trauma triage systems
Mass casualty triage
Summary
Prehospital Airway Management: Intubation, Devices, and Controversies
Diagnosis
Management
Prehospital surgical airways
Controversies in prehospital intubation
Conclusions and algorithms
Prehospital Fluid Resuscitation: What Type, How Much, and Controversies
Epidemiology
Causes of significant hemorrhage
Diagnosis and assessment
Classes of hemorrhagic shock
Management
Morbidity and complications
Summary
Civilian Hospital Response to Mass Casualty Events
Key definitions
Prehospital care in a mass casualty event
Hospital triage
Hospital emergency incident command system
Causes of mass casualty events
Communication during mass casualty
Conclusion
Injuries from Explosives
Incidence
Mechanisms of injury and diagnosis
Anatomic location of injury
Morbidity and mortality
Surgical management
Injury severity scoring
Conclusion
Prehospital Care of Biologic Agent–Induced Injuries
Anthrax
Smallpox
Plague
Botulism
Tularemia
Other agents
Summary
Wound Ballistics: What Every Trauma Surgeon Should Know
Ballistics theory
Handguns
Hunting rifles
Assault rifles
Shotguns
Nonlethal ammunition
Protective vests
Landmines and improvised explosive devices
Wound exploration and bullet removal
Common Prehospital Complications and Pitfalls in the Trauma Patient
Incidence
Airway
Breathing
Circulation
Disability
Transport
Comorbid conditions
Conclusion
Initial Assessment and Resuscitation
Airway Management: What Every Trauma Surgeon Should Know, From Intubation to Cricothyroidotomy
Airway anatomy
Assessing the airway
Controlling the airway
Documentation of proper endotracheal tube placement
Combitube
Endotracheal intubation
Surgical airway
Summary
Resuscitation Fluids
Choice of fluids
Resuscitation strategies
Complications of resuscitation
Resuscitative Thoracotomy
Historical perspective
Objectives
Physiology
Indications
Techniques for cardiac injury repair
Results
Focused Assessment with Sonography for the Trauma Patient
Brief history of the ultrasound
Fast training evolution
Principles of ultrasound
Using FAST
FAST technique
Extended FAST for thoracic trauma ultrasound
FAST algorithm
FAST scoring systems
Pediatric FAST
FAST: facts and evidence
Future of FAST
Role of Radiology in Initial Trauma Evaluation
Radiography
Ultrasound
Computed tomography
Magnetic resonance imaging
Management of iodine allergies
Skull and brain
Spine
Face
Vascular injuries
Nonvascular chest/thorax
Cardiac injuries
Diaphragmatic injuries
Focused assessment with sonography in trauma
Free fluid
Free air
Gastrointestinal tract
Mesenteric injuries
Solid organ injuries (liver, spleen, and kidneys)
Collecting system
Urethra
Retroperitoneal injuries
Pancreas
Adrenal glands
Bones other than spine
Shock
Resuscitation effects
Abdominal compartment syndrome
Interventional Radiology: Diagnostic and Therapeutic Roles
Computed tomography angiography
Transcatheter angiography
Pitfalls for the interventionalist
Solid organ injury
Pelvic trauma
Inferior vena cava filter placement for prophylatic embolic protection
Concluding discussion
Endpoints of Resuscitation
Clinical and hemodynamic end points
Metabolic end points
Regional perfusion end points
Summary
Head and Central Nervous System Injuries
Traumatic Brain Injury: Pathophysiology, Clinical Diagnosis, and Prehospital and Emergency Center Care
Incidence
Mechanism of injury
Clinical diagnosis
Initial clinical interventions: prehospital and emergency center care
Imaging modalities: what, when, and why?
Injury grading
Conclusions and algorithm
Traumatic Brain Injury: Imaging, Operative and Nonoperative Care, and Complications
Surgical management
Nonoperative management
Morbidity and complications
Mortality
Conclusions and algorithm
Spine: Spinal Cord Injury, Blunt and Penetrating, Neurogenic and Spinal Shock
Incidence
Anatomy and biomechanics
Mechanism of injury
Severity/grading of spinal cord injuries
Diagnosis
Management of acute spinal cord injury
Morbidity and complications management in spinal cord injury
Mortality
Conclusion
Maxillofacial and Ocular Injuries
Maxillofacial Trauma
Airway and breathing
Circulation and control of hemorrhage
History and physical examination
Radiographs
Soft tissue injuries
Facial fractures
Conclusions
Trauma to the Eye and Orbit
Incidence
Mechanism of injury
Diagnosis
Anatomic location of injury and injury grading—ocular trauma classification group
Medical and surgical management
Conclusions and algorithm
Neck Injuries
Penetrating Neck Injuries: Diagnosis and Current Management
Anatomy of the neck
Initial evaluation
Aerodigestive injury
Soft tissue injury
Thoracic duct injury
Vascular injury in the neck
Treatment of carotid artery injuries
Conclusion
Blunt Cerebrovascular Injuries
Signs and symptoms
Mechanism and patterns of injury
Diagnostic imaging
Injury grading scale
Incidence of blunt cerebrovascular injuries
Antithrombotic treatment
Role of endovascular stents
Long-term follow-up and outcome
Conclusions
Tracheal, Laryngeal, and Oropharyngeal Injuries
Anatomy of upper airway
Pharyngeal injury
Larynx
Trachea
Surgical management
Morbidity
Mortality
Thoracic Injuries
Pertinent Surgical Anatomy of the Thorax and Mediastinum
Chest wall
Muscles of the chest wall
Intercostal space
Pleural space
Diaphragm
Pericardium
Heart
Hilum of the lung
Lung anatomy
Aorta, trachea, esophagus, and thoracic duct
Thoracic Wall Injuries: Ribs, Sternal, and Scapular Fractures; Hemothoraces and Pneumothoraces
Incidence
Mechanism of injury
Diagnosis
American association for the surgery of trauma—organ injury scale grading
Management of specific injuries of the chest wall
Complications of hemopneumothorax
Conclusions
Diagnostic and Therapeutic Roles of Bronchoscopy and Video-Assisted Thoracoscopy in the Management of Thoracic Trauma
Incidence
Diagnostic and therapeutic roles of video-assisted thoracoscopic surgery
Diagnostic and therapeutic role of bronchoscopy
Conclusion
Pulmonary Contusion and Flail Chest
Incidence
Mechanisms of injury
Diagnosis
Anatomic location of injury and injury grading
Management
Mortality
Conclusions
Operative Treatment of Chest Wall Injury
Indications for operative therapy
Outcomes
Sternal fractures
Conclusions
Tracheal and Tracheobronchial Tree Injuries
Incidence and mechanisms of injury
Diagnosis
Management
Outcomes
Operative Management of Pulmonary Injuries: Lung-Sparing and Formal Resections
Incidence
Etiology
Classification
Diagnosis
Associated injuries
Anatomic location of injury
Management
Surgical techniques of repair and resection
Prognostic factors and outcomes
Morbidity
Mortality
Conclusions
Complications of Pulmonary and Pleural Injury
Pulmonary complications
Pleural complications
Surgical therapy points
Cardiac Injuries
Penetrat