TRAUMA
Author: David Feliciano, MD, Kenneth Mattox, MD, Ernest Moore, MD
Publisher: McGraw-Hill
Publication Date: 2008
Publisher: McGraw-Hill
Publication Date: 2008
ISBN 10: 0071469125
ISBN 13: 9780071469128
Edition: 6th
ISBN 13: 9780071469128
Edition: 6th
Description:
The most trusted, widely used guide to managing the trauma patient-now in a 2-color format with added algorithms This definitive one-stop resource begins with an informative look at the history and epidemiology of trauma surgery, as well as injury prevention, before moving into core topics such as trauma systems, triage, and transport, and managing shock. It then delivers a clear, organ-by-organ overview of the treatment of traumatic injuries, from the cranium and brain to pelvic fractures, while covering need-to-know subjects such as anesthesia and infection.
Table of Contents
Front Matter
History of Trauma Care
- History of Trauma Care: Introduction
- The Practice of Medicine in Ancient Greece
- Contributions of the Roman Empire to Medicine
- Medical Advances during the Middle Ages
- Medical Advances during the Renaissance
- Medical Advances during the 17th Century
- Medical Advances during the 18th Century
- Medical Advances during the 19th Century
- Medical Advances during the 20th Century
- Fracture Fixation and Early Ambulation
- Imaging as Related to Trauma Patients
- Weapons, Campaigns, and Trauma Pioneers
- Gunpowder
- Early German Surgeons
- The French and Indian War
- American Revolutionary War
- Dominique Jean Larrey
- The Advent of Nursing Care
- The War between the States
- Franco-Prussian War
- The Spanish-American War
- World War I
- World War II
- The Korean Conflict
- The Vietnam War
- Conflicts since Vietnam
- Organizations and Societies
- The Future
- References
- Commentary
Epidemiology
- Epidemiology: Introduction
- Overview
- Overall Injury Patterns by Age and Gender
- Patterns of Injury by Mechanism and Intent
- Distribution of Injuries by Their Nature and Severity
- Distribution of Injuries by Place
- Trends in the Rates of Injury over Time
- Leading Mechanisms of Major Trauma: Motor Vehicles, Firearms, and Falls
- Motor Vehicle Injuries
- Firearm-Related Injuries
- Falls
- Data Sources
- National Data Sources
- State and Local Sources of Injury Data
- Conclusion
- References
- Commentary
Injury Prevention
Trauma Systems, Triage, and Transport
- Definition of Trauma System
- The Need for Trauma Systems—History
- Trauma Systems Development
- Trauma System Components
- Public Information, Education, and Injury Prevention
- Human Resources
- Prehospital
- Communication System
- Medical Direction
- Triage & Transport
- Purpose and Challenges of Triage
- Components of Triage Tools and Decision-Making
- Physiologic Criteria
- Anatomic Criteria
- Mechanism of Injury
- Age, Comorbid Disease, and Environmental Concerns
- Paramedic Judgment
- Current Field Methods for Field Triage Scoring
- Specific Triage Methods-Definitions
- Application of Triage Principles for Multiple Patient Scenarios
- Current Evidence for Triage Guidelines
- Improved Outcome from Transfer
- Mode of Transport-Interfacility Transfer
- Trauma Center Facilities and Leadership
- Rehabilitation
- System Evaluation
- Trauma System Quality Improvement (Q/I)
- Standardized Definition of Errors and Preventable Death
- Analysis of Trauma System Performance
- Special Problems
- References
- Commentary
Injury Severity Scoring and Outcomes Research
Trauma Outcomes
Kinematics of Trauma
Prehospital Care
- Prehospital Care: Introduction
- Historical Perspective
- Emergency Medical Services System
- Personnel
- System Design
- Equipment
- Communications
- Transport Modalities
- Air Medical EMS
- Continuous Quality Improvement
- Medical Control
- Trauma Education for EMS Personnel
- Assessment and Management
- Percutaneous Transtracheal Ventilation
- Resuscitation
- Secondary Survey
- Specific Conditions
- Triage
- Prehospital Research
- Golden Principles
- References
- Commentary
Trauma Care in Mass Casualty Incidents
- Trauma Care in Mass Casualty Incidents: Introduction
- General Considerations
- Blast Trauma in the Civilian Setting
- Trauma Care Aspects of the Prehospital Response
- Organization of the Hospital Response
- Hospital Care in Mass Casualty Incidents
- Trauma Care in Major Natural Disasters
- Conclusion
- References
- Commentary
Rural Trauma
- The Rural Environment
- Defining Rural
- Epidemiology
- Rural Resources and Limitations
- Manpower
- Communications
- Transport
- Facilities
- Education and Maintenance of Skills
- Treatment Options
- Operative Stabilization and Transfer
- Local Definitive Care
- Wireless Technology
- Transport
- Telemedicine
- Telepresence Surgery
- Trauma Systems
- References
- Commentary
Initial Assessment and Management
Airway Control
- Airway Control: Introduction
- Basic Airway Equipment and Preparation
- Assessment of the Airway
- Intubation of the Trachea
- Rapid Sequence Intubation
- Pharmacology of Rapid Sequence Intubation
- Alternatives and Adjuncts to Endotracheal Intubation
- Airway Challenges in the Injured Patient
- The Pediatric Airway
- Emergency Airway Algorithms
- Complications Associated with the Emergency Airway
- References
- Commentary
Management of Shock
Transfusion, Autotransfusion, and Blood Substitutes
Emergency Department Thoracotomy
- Emergency Department Thoracotomy: Introduction
- Historical Perspective
- Definitions
- Physiologic Rationale for EDT
- Clinical Results Following EDT
- Indications for EDT
- Technical Details of EDT
- Complications and Consequences of EDT
- Optimizing Oxygen Transport Following EDT
- Future Considerations
- References
- Commentary
Diagnostic and Interventional Radiology
Surgeon-Performed Ultrasound in Trauma and Surgical Critical Care
Anesthesia
Infection
The Brain
Injury to the Eye
- Historical Perspective
- Epidemiology of Eye Injuries
- Function and Anatomy
- Classification of Ocular Trauma
- Initial Evaluation
- History
- Physical Examination
- Visual Acuity
- Ancillary Studies
- Counseling the Patient with an Injury to the Eye
- Transporting the Patient with an Injury to the Eye
- Specific Injuries and Their Management
- Chemical Injury
- Corneal Abrasion
- Corneal Foreign Body
- Subconjunctival Hemorrhage and Conjunctival Laceration
- Blunt Ocular Trauma
- Open Globe
- Endophthalmitis
- Closed Globe
- Injuries to the Retina
- Injury to Cranial Nerves
- Orbital Injuries
- Lacerations of the Eyelid
- Pediatric Trauma
- Injury Prevention
- Acknowledgment
- References
- Commentary
Face
Management of Acute Neck Injuries
Injury to the Vertebrae and Spinal Cord
- Introduction
- Anatomy and Kinematics of Vertebral Column
- Anatomy and Physiology of the Spinal Cord
- Acute Injury to Vertebral Column
- Acute Spinal Cord Injury
- Neurological Patterns of Spinal Cord Injury
- Injury Diagnosis and Acute Management
- Nonoperative Management of Spine Injuries
- Surgical Management of Spine Injury
- Specific Spinal Injury Characteristics
- Gunshot Injury to the Spine
- Complications
- References
- Commentary
Indications for and Techniques of Thoracotomy
Chest Wall and Lung
- Chest Wall and Lung: Introduction
- Chest Trauma in History
- History and Physical Examination in Chest Trauma
- Diagnostic Radiology in Chest Trauma
- Trauma to the Chest Wall
- Other Injuries to the Chest Wall
- Pneumothorax
- Hemothorax
- Video-Assisted Thoracoscopic Surgery (VATS) in Trauma
- Lung Injuries
- The Critical Care of Chest Trauma
- Causes of Pulmonary Dysfunction after Chest Trauma
- Management of Pulmonary Dysfunction after Chest Trauma
- Tracheostomy in Chest Trauma
- Chest Wall Stabiliztion
- Pain Control in Chest Trauma
- Complications and Other Conditions
- Disability Following Chest Trauma
- References
- Commentary
Esophagus, Trachea, and Bronchus
- Trachea and Bronchus
- Incidence
- Mechanism
- Associated Injuries
- Diagnosis
- Stabilization and Prioritization of Associated Injuries
- Anesthetic Management
- Nonoperative Management
- Surgical Management
- Postoperative Management
- Complications
- Late Management
- Results
- Incidence and Mechanism
- Diagnosis
- Management
- Complications
- References
- Commentary
Trauma to the Heart
Thoracic Great Vessel Injury
Indications for and Techniques of Laparotomy
Injury to the Diaphragm
Liver and Biliary Tract
Injury to the Spleen
- Injury to the Spleen: Introduction
- Historical Perspective
- Splenic Function
- Splenic Anatomy
- Pathophysiology of Injury
- Initial Evaluation and Management
- Imaging and Diagnostic Peritoneal Lavage
- Splenic Injury Grading Systems
- Nonoperative Management
- Patient Selection
- Patient Management
- Operative Management
- Complications of Splenic Injury and Management
- Postoperative Complications
- Overwhelming Postsplenectomy Sepsis
- References
- Commentary
Stomach and Small Bowel
Duodenum and Pancreas
Colon and Rectum
Abdominal Vascular Injury
- Abdominal Vascular Injury: Introduction
- Epidemiology
- Pathophysiology
- Diagnosis
- Initial Management and Resuscitation
- Operative Preparations
- Management of Injuries in Zone 1: Supramesocolic Region
- Management of Injuries in Zone 1: Inframesocolic Region
- Management of Injuries in Zone 2
- Management of Injuries in Zone 3
- Management of Injuries in the Porta Hepatis
- Adjuncts to Operative Therapy
- Complications
- Summary
- References
- Commentary
Pelvic Fractures
- Pelvic Fractures: Introduction
- History
- Pelvic Osseous Anatomy
- Biomechanics of Pelvic Fracture
- Pelvic Fracture Classification
- Diagnosis of Pelvic Fracture
- Management
- Priorities in Polytrauma
- Controlling Pelvic Hemorrhage
- Role of Compressive Devices
- Role of External Fixation
- Staged and Definitive Use of External Fixators
- Role of Selective Embolization
- Role of Operative Hemostasis
- The Authors' Approach
- Management of Open Pelvic Fractures
- Definitive Treatment of Pelvic Ring Disruptions
- Timing of Operative Treatment of Pelvic Ring Disruptions
- Techniques of Fixation
- Associated Injuries
- Delayed Complications
- Outcomes
- References
- Commentary
Genitourinary Trauma
- Introduction
- Anatomy
- Injury Grading and Scoring Systems for Genitourinary Injuries
- Clinical Presentation and Diagnosis of Renal Trauma
- Pediatric Renal Trauma
- Clinical Presentation and Diagnosis of Trauma to the Ureter, Bladder, Urethra, and External Genitalia
- Nonoperative Management of Genitourinary Injuries
- Operative Management of Specific Genitourinary Injuries
- Complications of Genitourinary Trauma
- Damage Control Principles in Genitourinary Trauma
- Consultation and Interservice Interaction
- Medicolegal Considerations
- Conclusions
- References
- Suggested Readings
- Commentary
Reproductive System Trauma
- Reproductive System Trauma: Introduction
- Epidemiology of Trauma in Pregnancy
- Anatomic and Physiologic Changes Unique to Pregnancy
- Initial Assessment and Management
- Management of Injuries during Pregnancy
- Critical Care Obstetrics
- Predicting Outcome Following Trauma and Pregnancy
- Injury Prevention during Pregnancy
- Trauma in the Nonpregnant Patient
- Evaluation and Treatment
- Injury Prevention
- References
- Commentary
Trauma Damage Control
- Trauma Damage Control: Introduction
- Damage Control Operations
- Indications for Alternate Closures of Incisions
- Abdominal Compartment Syndrome
- Operative Techniques for the Open Abdomen
- Intensive Care before Reoperation
- Reoperation
- What Happens to Patients When a Vacuum-Assisted Closure Is Not Used?
- Late Closure of the Incisional Hernia
- References
- Commentary
Upper Extremity Injury
Lower Extremity
- Introduction
- Historical Perspective
- Current Concepts
- Limb Salvage versus Amputation
- Replantation
- Open Fractures
- Importance of Early Recognition and Treatment of Extremity Injuries
- Injury Combinations
- Pathophysiology and Biomechanics
- Diagnosis
- Management of Common Fractures and Dislocations
- Rehabilitation
- Late Complications
- Conclusion
- References
- Commentary
Peripheral Vascular Injury
Alcohol and Drugs
Pediatric Trauma
- Pediatric Trauma: Introduction
- Epidemiology of the Injured Child
- Initial Assessment and Resuscitation of the Injured Child
- Diagnostic Assessment
- Management of Specific Injuries
- Pediatric Critical Care
- Pediatric Rehabilitation
- Child Abuse
- Emergency Department Management and Family Relations
- References
- Commentary
Geriatric Trauma
Family and Youth Violence
Wounds, Bites, and Stings
Burns and Radiation Injuries
Temperature-Associated Injuries and Syndromes
Organ Procurement for Transplantation
Reconstructive Surgery After Trauma
Rehabilitation
Modern Combat Casualty Care
Weapons of Mass Destruction
- Terrorism
- Federal Bureau of Investigation 1
- Blast Injury
- Crush Injury
- Nerve Agents
- Blood Agents
- Pulmonary Agents
- Special Considerations in Pregnancy
- Viral Hemorrhagic Fevers
- Radiologic Terrorism
- Radiologic Dispersal Devices (RDDs)
- Field Source Radiation or Passive Emission
- Types of Radiation
- Units of Radiation
- Radiation Time Profile
- Acute Radiation Syndrome
- Management of the Neutropenic Fever
- Pregnancy and Radiation
- Summary
- Acknowledgments
- References
- Commentary
Genetic Influence on Response and Outcome
The Convergence of Trauma, Medicine, and the Law
- Introduction
- Access to the Injured
- Trauma Systems and the Law
- The Good Samaritan
- Delivery
- Destination
- The Obligation to Treat
- Transfer Arrangements
- Consent for Therapy
- Confidentiality
- The Malpractice Challenge
- Futile Care of the Trauma Patient
- Initiating Legislative Changes
- Authorization and Funding
- Successful Trauma Legislation
- References
- Commentary
Acute Care Surgery
Principles of Critical Care
- Principles of Critical Care: Introduction
- Historical Perspectives
- Organization of the Critical Care Unit
- Performance Improvement and Resource Utilization
- Physiologic Monitoring in the Critical Care Unit
- Hemodynamic Monitoring
- Transesophageal Echocardiography
- Arterial Base Deficit
- Gastric Tonometry
- Erythropoietin in the Intensive Care Unit
- Neurological Monitoring
- Jugular Venous Saturation Monitoring and Brain Tissue Oxygen Monitoring
- Nutritional Monitoring
- Tight Glycemic Control in the Intensive Care Unit
- Adrenal Insufficiency in the Critically Ill
- Infectious Monitoring and Surveillance
- Mechanical Ventilation
- Monitoring of Gas Exchange
- Monitoring of Ventilation
- Assessment of Lung Mechanics and Inspiratory/Expiratory Pressures
- Ventilatory Capacity
- General Management of Mechanical Ventilation
- Ventilator-Induced Lung Injury
- Ventilatory Modes
- Control-Mode and Assist/Control-Mode Ventilation
- Pressure–Regulated Volume-Controlled Ventilation (PRVC)
- Intermittent Mandatory Ventilation
- Pressure Support Ventilation
- Time-Cycled Pressure-Control Ventilation
- Airway-Pressure-Release Ventilation
- High-Frequency Oscillatory Ventilation
- Adjuvant Therapies in Respiratory Failure
- Weaning from Mechanical Ventilation
- Weaning and Work of Breathing
- Weaning and Ventilatory Capacity
- Weaning versus Extubation
- The Weaning Process
- Therapist-Driven Protocols for Weaning Mechanical Ventilation
- Tracheostomy: Timing and Methods
- Analgesia and Conscious Sedation
- Choice of Parenteral Opioid for Analgesia in Critically Ill Adults
- Parenteral Agents for the Treatment of Anxiety in Adult Critical Care Unit Patients
- Monitoring and the Daily Interruption of Sedation in Critical Care Unit Patients
- The Use of Intravenous Haloperidol in Critical Care Unit
- Utility of Regional Analgesia and Anesthesia in the Setting of Blunt Trauma
- Complications of Critical Care
- Ventilator-Associated Pneumonia
- Unplanned Extubations
- Central Venous Catheter Infections
- Microbial Resistance in the Critical Care Unit
- Critical Illness Polyneuropathy
- Ethical Issues in Critical Care
- Ethical Principles Applicable to Medical Decision Making
- Withdraw/Withhold Support Decisions
- Futility
- Decision-Making Capacity and the Exercise of Autonomy
- Decision Making in the Absence of Decision-Making Capacity
- Conflict Resolution
- Do Not Resuscitate Orders
- References
- Commentary
Bleeding and Coagulation Complications
- Bleeding and Coagulation Complications: Introduction
- Hemostasis
- Primary Hemostasis
- Secondary Hemostasis
- Fibrinolysis and Regulation of Thrombosis
- Bleeding Problems with Massive Transfusion
- Thermal Load
- Acid-Base Changes
- Changes Due to Citrate
- Changes in Potassium
- Changes in 2,3-Diphosphoglycerate
- Hemostasis
- Acquired Disorders of Bleeding and Coagulation
- Congenital Disorders of Bleeding and Coagulation
- von Willebrand Disease
- Other Congenital Deficiencies
- Evaluation of Bleeding and Coagulation
- Treatment with Hemoactive Drugs
- Future Directions
- References
- Commentary
Cardiovascular Failure
- Introduction
- Determinants of Cardiac Output
- Myocardial Dysfunction
- Management of Myocardial Dysfunction
- Evaluation of Cardiac Function
- Management of Right and Left Heart Air Embolus
- Myocardial Protection
- Current Treatment of Acute Myocardial Infarction
- Management of Diastolic Dysfunction
- References
- Commentary
Respiratory Insufficiency
- Respiratory Insufficiency: Introduction
- Hypercapnic Pulmonary Failure
- Hypoxic Pulmonary Failure
- ALI and ARDS
- Current Definitions and Their Limitations
- Epidemiology and Risk Factors
- Risk Factors
- Pathology
- Pathogenesis
- Leukocytes and Pulmonary Epithelium
- Macrophages
- Endothelium
- Humoral Mediators
- Cytokines
- Lipid Mediators
- The Gut Lymph Hypothesis
- Biological Markers of Acute Respiratory Distress Syndrome
- Pathophysiology
- Gas Exchange
- Pulmonary Mechanics
- Cardiopulmonary Hemodynamics
- Presentation
- Management
- Fluid Management and Hemodynamic Support
- Mechanical Ventilation
- Positive End-Expiratory Pressure
- Pressure-Limited Ventilatory Support
- Permissive Hypercapnia
- Pressure Control and Inverse Ratio Ventilation
- Prone Ventilation
- Tracheal Gas Insufflation
- High-Frequency Ventilation
- Extracorporeal Life Support
- Partial Liquid Ventilation
- Pharmacologic Therapy
- Surfactant Replacement Therapy
- Corticosteroids
- Infection Surveillance and Management
- Outcome
- References
- Commentary
Gastrointestinal Failure
Acute Renal Failure
- Acute Renal Failure: Introduction
- Definitions
- Incidence and Risk Factors
- Normal Renal Physiology
- Pathophysiology
- Acute Intrinsic Renal Failure
- Pathophysiology of Acute Tubular Necrosis
- Repair of Renal Injury
- Acute Renal Failure Syndromes
- Aminoglycosides
- Polyene Macrolides
- Contrast-Induced Nephropathy
- Pigment-Induced Nephropathy
- Nonsteroidal Anti-Inflammatory Drugs
- Abdominal Compartment Syndrome
- Sepsis
- Effects on Other Organ Systems
- Diagnosis and Management
- Early Detection of Renal Dysfunction
- Rule Out Obstruction
- Rule Out Prerenal Dysfunction
- Diagnose Renal Parenchymal Injury
- Optimize Renal Perfusion/Oxygen Delivery
- Diuretics
- Eliminate or Minimize All Nephrotoxic Agents
- Renal Replacement
- Nutrition
- Drug–Kidney Interactions
- Experimental Approaches
- Outcomes
- References
- Commentary
Nutritional Support and Electrolyte Management
- Nutritional Support and Electrolyte Management: Introduction
- Postinjury Hypermetabolism
- The Endocrine Response to Stress and Injury
- Changes in Intermediary Metabolism with Stress and Sepsis
- Enteral versus Parenteral Feeding: The Clinical Argument
- Determining Indicators for Enteral (Postpyloric) Access during Celiotomy for Trauma
- Influence of the Type of Enteral Feeding on Infectious Complications
- Possible Deleterious Affects of Immunonutrition in the Critically Ill
- Potential Reasons for Improved Outcome with Enteral Feeding
- The Nutrient Prescription: Issues Common to Enteral or Parenteral Feeding
- Estimating Nutritional Needs
- Energy Requirements and Feeding Recommendations in the Morbidly Obese
- Fat Requirements
- Protein Requirements
- The Formula
- Pulmonary Failure
- Hepatic Failure
- Fluid and Electrolytes
- Issues of Relevance to Enteral Feeding
- Diet Choice by the Enteral Route
- Diet Progression
- Prokinetic Agents
- Drug-Nutrient Interactions
- Complications of Enteral Feeding
- Pneumatosis Intestinalis and Necrosis
- Aspiration
- Mechanical Complications
- Parenteral Feeding
- Formula Preparation
- Institution of Therapy
- Complications of Parenteral Nutrition and Their Treatment
- Transition to Enteral Nutrition
- Monitoring Therapy
- Anabolic Agents in Trauma Patients
- References
- Commentary
The Immune Response
- The Immune Response: Introduction
- Traumatic Injury and Systemic Inflammatory Response
- Mechanisms of Inflammation
- Dynamic Stages in the Immune Response to Trauma
- Trauma-Induced Changes in Immune Function
- Polymorphonuclear Neutrophil Abnormalities
- Monocytes and Macrophages
- T-Cell Function and Polarization of the Adaptive Immune Response
- Cytokines and Soluble Mediators
- TNF-α, Interleukin-1, and Their Natural Antagonists
- Clinical Implications in Monitoring the Immune Response to Injury
- Rationale for Therapeutic Intervention and Suitable Concepts
- Genetic Contribution to Inflammation and Immune Function
- References
- Commentary
Multiple Organ Failure
Topics within this title:
- Acute Renal Failure
- Bites and Stings
- Brain Swelling
- Burn
- Burns
- Cardiogenic Shock
- Compartment Syndrome
- Computed tomography
- continuous quality improvement
- Cranium
- CT
- Dislocations
- duration
- Embolus
- Emergency
- Esophageal Perforation
- Eye Injuries
- Facial Injury
- Fever
- Fevers
- Fracture
- Fractures
- Head Injuries
- Hypertension
- Hypothermia
- Hypovolemic
- Hypovolemic Shock
- Infarction
- intubation
- Lacerations
- Magnetic resonance imaging
- Mechanical Ventilation
- Multiple Organ Failure
- Myocardial Infarction
- Neck Injuries
- Necrosis
- Nosocomial Infections
- Pain
- Pneumonia
- Postoperative Complications
- Radiation Injuries
- Radiation Syndrome
- Renal Failure
- Respiratory Insufficiency
- Rhabdomyolysis
- Sepsis
- Septic Shock
- Shock
- Snake Bites
- Soft Tissue Injuries
- Spinal Cord Injury
- Stings
- Syndrome
- Syndromes
- Temperature
- Toxicity
- Trachea
- Trauma
- Tularemia
- Ventilation
- Viral Hemorrhagic Fevers
- withhold