Trauma Care Manual PDF
Preview Trauma Care Manual
Trauma Care Manual Second edition This page intentionally left blank Trauma Care Manual Second Edition Edited by Ian Greaves Visiting Professor of Emergency Medicine University of Teeside and Consultant in Emergency Medicine British Army Keith Porter Chairman of Trauma Care and Honorary Professor of Clinical Traumatology University of Birmingham and Consultant Trauma Surgeon Selly Oak Hospital Birmingham and Immediate Care Practitioner UK Jeff Garner Specialist Registrar in General Surgery Defence Medical Services UK PART OF HACHETTE LIVRE UK First published in Great Britain in 2001 by Arnold, a member of the Hodder Headline Group This second edition published in 2009 by Hodder Arnold, part of Hachette UK, 338 Euston Road, London NW1 3BH. http://www.hoddereducation.com © 2009 Edward Arnold (Publishers) Ltd All rights reserved. Apart from any use permitted under UK copyright law, this publication may only be reproduced, stored or transmitted, in any form, or by any means with prior permission in writing of the publishers or in the case of reprographic production in accordance with the terms of licences issued by the Copyright Licensing Agency. In the United Kingdom such licences are issued by the Copyright Licensing Agency: Saffron House, 6-10 Kirby Street, London EC1N 8TS. Hachette Livre UK’s policy is to use papers that are natural, renewable and recyclable products and made from wood grown in sustainable forests. The logging and manufacturing processes are expected to conform to the environmental regulations of the country of origin. Whilst the advice and information in this book are believed to be true and accurate at the date of going to press, neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made. In particular (but without limiting the generality of the preceding disclaimer) every effort has been made to check drug dosages; however it is still possible that errors have been missed. Furthermore, dosage schedules are constantly being revised and new side-effects recognized. For these reasons the reader is strongly urged to consult the drug companies’ printed instructions before administering any of the drugs recommended in this book. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data A catalog record for this book is available from the Library of Congress ISBN-13 978 0 340 928 264 1 2 3 4 5 6 7 8 9 10 Commissioning Editor: Gavin Jamieson Project Editor: Francesca Naish and Eva Senior Production Controller: Joanna Walker Cover Designer: Helen Townson Indexer: Laurence Errington Typeset in 10/12 pt Minionby Phoenix Photosetting, Chatham, Kent Printed and bound in the UKby MPG Books, Bodmin, Cornwall Text printed on FSC accredited material What do you think about this book? Or any other Hodder Arnold title? Please visit our website: www.hoddereducation.com This edition is dedicated to Professor James M. Ryan. This page intentionally left blank Contents Contributors ix Preface to the Second Edition xi Preface to the First Edition xiii Trauma Care xv Pre-hospital care 1. The trauma epidemic 1 2. Mechanism of injury 11 3. Triage 17 Initial assessment 4. Patient assesment 25 5. Control of catastrophic haemorrhage 37 6. Airway management 43 7. Thoracic injury 63 8. Shock 83 Regional survey 9. Head injury 99 10. Maxillofacial injuries 113 11. Ophthalmic injuries 125 12. Spinal injuries 135 13. Abdominal trauma 147 14. Musculoskeletal trauma 159 Special circumstances 15. Injuries in children 173 16. Trauma in women 193 17. Trauma in the elderly 201 18. Gunshot injuries 209 19. Blast injury 215 20. Injuries due to burns and cold 223 Ongoing care 21. Analgesia and anaesthesia for the trauma patient 237 22. Intensive care management of major trauma 253 23. Patient transfer 263 24. Psychological reactions to trauma 277 25. Rehabilitation after trauma 287 26. Trauma scoring 297 27. Organ donation 305 Index 315 This page intentionally left blank Contributors Professor David A. Alexander MA (Hons) C Psychol PhD FBPS FRSM HonFRCPsych Lt Col S.L.A. Jeffery FRCS (Plast) RAMC Professor of Mental Health, Director, Aberdeen Centre for Trauma Consultant Plastic Surgeon, Royal Centre for Defence Medicine, Research, The Robert Gordon University, Aberdeen, UK Selly Oak, Birmingham, UK Mr Keith AllisonMB ChB MD FRCS(Eng) FRCS(Plast) FIMC.RCSEd Major Andrew Johnston MRCPI DMCC RAMC Consultant Plastic Surgeon, Selly Oak Hospital, Birmingham, UK Specialist Registrar in Respiratory and Intensive Care Medicine, University Hospital Birmingham; Defence Medical Services, UK Mr Ranjeev Singh Bhangoo MB ChB(Hons) FRCS(Eng) FRCS(SN) Consultant Neurosurgeon, King’s College Hospital, London, UK Dr Tim Jones BA FRCP(UK) Dr Stephen Bonner MRCP FRCA Consultant Rheumatology and Rehabilitation Medicine, Defence Consultant in Anaesthesia and Intensive Care Medicine, The Medical Rehabilitation Centre, Headley Court, UK James Cook University Hospital, Middlesbrough, UK Dr Susan Klein MA(Hons) Cert [COSCA] PhD Dr Stephen J. BrettMD FRCA Senior Clinical Research Fellow, Aberdeen Centre for Trauma Consultant in Intensive Care Medicine, Imperial College Research, The Robert Gordon University, Aberdeen, UK Healthcare NHS Trust, Hammersmith Hospital, London, UK Dr Roderick Mackenzie BSc PhD MRCPFCEM Major M. Leigh Davies MRCS RAMC Emergency Physician, University Hospitals Leicester NHS Trust, Specialist Registrar in General Surgery, Defence Medical Services, Leicester, UK UK Dr Paul M. Middleton RGN MB BS FRCS(Eng) DipIMCRCS(Ed) FCEM FACEM Mr Peter Driscoll BSc MD FCEM Specialist Emergency Physician, Prince of Wales Hospital; Consultant in Emergency Medicine, Hope Hospital, Stott Lane, Conjoint Senior Lecturer in Emergency Medicine, Public Health Salford, UK and Community Medicine, University of New South Wales; Visiting Medical Fellow, Biomedical Systems Laboratory, NSW, Dr J. Michael Elliot MB BS FRCA DipIMC RCSEd Australia Consultant in Anaesthesia and Intensive Care, Good Hope Hospital, Sutton Coldfield, West Midlands, UK Dr Alan Mistlin MRCP(UK) MSc (Sports Medicine) FFSEM Consultant in Rheumatology and Rehabilitation Medicine, Major Jeff Garner MB ChB MD MRCS(Glas) FRCSEd(Gen Surg) RAMC Defence Medical Rehabilitation Centre, Headley Court, UK Specialist Registrar in General Surgery, Defence Medical Services, UK; Member of Trauma Care Council Dr Jane S. Mooney BSc (Hons) MB ChB (Hons) Professor Ian Greaves MB ChB FRCP FCEM FIMC.RCSEd MIHM DipMedEd DMCC Department of Emergency Medicine, Hope Hospital, Stott Lane, Salford, UK DTM&H RAMC Visiting Professor of Emergency Medicine, University of Teesside; Dr Peter Oakley MB BChir (Camb) MA MRCGP FFA RCS(Ed) Consultant in Emergency Medicine, The James Cook University Consultant Anaesthetist, University Hospital of North Hospital, Middlesbrough; Defence Medical Services, UK; Honorary Staffordshire, Hartshill, Stoke on Trent, UK Secretary of Trauma Care Council Mr David W. Patton TD FDS FRCS Mr Jonathan Hull MD FRCS(Orth) Consultant/Honorary Senior Lecturer in Oral and Maxillofacial Consultant Orthopaedic Surgeon, Frimley Park Hospital NHS Surgery, Morriston Hospital, Swansea; Honorary Civilian Foundation Trust, Camberley, Surrey, UK Consultant in Oral and Maxillofacial Surgery to the Army Dr Paul Hunt MB BS DipIMC (RCSEd) MCEM MRCSEd DMCC Dr David Pedley MB ChB MRCP(UK) FRCS(Edin) FCEM Specialist Registrar in Emergency Medicine and Critical Care FormerlyConsultant in Emergency Medicine,TheJames Cook Medicine, Doctoral Research Fellow in Emergency Medicine, The University Hospital, Middlesbrough, UK James Cook University Hospital, Middlesbrough, UK Professor Keith Porter MB BS FRCS(Eng) FRCSEd FIMC.RCSEd FSEM Dr Graham Jay FCEM FACEM Professor of Military Traumatology, University of Birmingham; Consultant and Senior Lecturer, Children’s Emergency Consultant in Trauma, University Hospital Birmingham; Chairman Department, Mater Children’s Hospital, Brisbane, Australia of Trauma Care
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