BOOK
Current Therapy of Trauma and Surgical Critical Care E-Book
Donald D. Trunkey | Juan A. Asensio
(2015)
Additional Information
Book Details
Abstract
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.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Inside Front Cover | ES2 | ||
| Current Therapy of Trauma and Surgical Critical Care | iii | ||
| Copyright | iv | ||
| Contributors | v | ||
| Foreword | xvii | ||
| Preface | xix | ||
| If- | xix | ||
| Contents | xxi | ||
| Part I: Trauma Systems | 1 | ||
| Development of Trauma Systems | 1 | ||
| Modern trauma system development | 2 | ||
| Are trauma systems effective? | 3 | ||
| What are the current problems? | 3 | ||
| Solutions | 4 | ||
| Trauma Center Organization and Verification | 5 | ||
| Suggested readings | 5.e1 | ||
| Trauma Center Organization and Verification | 5.e2 | ||
| Trauma system and trauma center organization | 5.e2 | ||
| Trauma System Organization | 5.e2 | ||
| Trauma Center Organization | 5.e2 | ||
| Trauma Medical Director | 5e.1 | ||
| Trauma Program Manager/Trauma Nurse Coordinator | 5e.1 | ||
| Trauma Registrar | 5e.1 | ||
| Trauma performance improvement process | 5e.2 | ||
| Trauma center verification | 5e.2 | ||
| Consultation | 5e.2 | ||
| Verification | 5e.2 | ||
| Suggested Readings | 5e.2 | ||
| Injury Severity Scoring: Its Definition and Practical Application | 6.e1 | ||
| Injury description and scoring: conceptual background | 6.e1 | ||
| Testing a test: statistical measures of predictive accuracy and power | 6.e2 | ||
| Measuring anatomic injury | 6.e3 | ||
| Measuring physiologic injury | 6.e5 | ||
| Measuring physiologic reserve and comorbidity risk | 6.e6 | ||
| More powerful predictions: combining several types of information | 6.e6 | ||
| Statistical considerations | 6.e9 | ||
| Improved prediction in trauma scoring | 6.e10 | ||
| How Good Are Current Scoring Systems? | 6.e10 | ||
| The Uses of Injury Scoring | 6.e10 | ||
| Recommendations | 6.e11 | ||
| Conclusions | 6.e11 | ||
| Suggested Readings | 6.e11 | ||
| Role of Alcohol and Other Drugs in Trauma | 6.e12 | ||
| Epidemiology | 6.e12 | ||
| Alcohol | 6.e12 | ||
| Drugs | 6.e12 | ||
| Effects of alcohol and drugs on management and outcome | 6.e12 | ||
| Alcohol and injury recidivism | 6.e13 | ||
| Withdrawal syndromes: prophylaxis and treatment | 6.e13 | ||
| Definition of alcohol and drug problems | 6.e13 | ||
| Rationale for brief alcohol interventions in trauma centers | 6.e14 | ||
| Screening for Alcohol and Drug Problems | 6.e14 | ||
| Goals of Brief Interventions | 6.e15 | ||
| Brief Intervention Techniques | 6.e15 | ||
| Summary | 6.e15 | ||
| Key Points | 6.e15 | ||
| Suggested Readings | 6.e16 | ||
| Role of Trauma Prevention in Reducing Interpersonal Violence | 6.e17 | ||
| Understanding the problem | 6.e17 | ||
| Impact of enhanced trauma commitment on patient outcomes | 6.e17 | ||
| In-hospital prevention: shortcomings | 6.e17 | ||
| Effectiveness of a violence prevention program | 6.e17 | ||
| Culture of violence | 6.e18 | ||
| Suggested Readings | 6.e19 | ||
| Trauma Scoring | 6.e20 | ||
| Anatomic scoring systems | 6.e20 | ||
| Abbreviated Injury Scale | 6.e20 | ||
| Injury Severity Scale | 6.e20 | ||
| Anatomic Profile and New Injury Severity Score | 6.e21 | ||
| ICD-9 Injury Severity Score | 6.e21 | ||
| Physiologic scoring systems | 6.e22 | ||
| Glasgow Coma Scale | 6.e22 | ||
| Revised Trauma Score | 6.e22 | ||
| Acute Physiology and Chronic Health Evaluation | 6.e22 | ||
| Physiologic Reserve | 6.e22 | ||
| Risk-adjustment scoring systems | 6.e22 | ||
| Trauma and Injury Severity Score | 6.e22 | ||
| A Severity Characterization of Trauma | 6.e23 | ||
| Mechanism of Injury | 6.e23 | ||
| Scoring systems evaluation | 6.e23 | ||
| Data Collection | 6.e23 | ||
| Databases | 6.e23 | ||
| Outcome Measures | 6.e23 | ||
| Summary | 6.e24 | ||
| Suggested Readings | 6.e24 | ||
| Results of the Medical Strategy for Military Trauma in Colombia | 7 | ||
| Knowing the Primary Enemy | 7 | ||
| Knowing the Secondary Enemy | 8 | ||
| Strategic Plan for Medical Care | 9 | ||
| Results of the Strategy | 9 | ||
| Conclusions | 13 | ||
| Suggested Readings | 13.e1 | ||
| Part II: Prehospital Trauma Care | 15 | ||
| Influence OF Emergencymedical Services Onoutcome Attrauma Center | 15 | ||
| Golden hour or golden opportunity? | 15 | ||
| Prehospital fluids | 16 | ||
| To bleed or not to bleed-should tourniquets be standard care? | 16 | ||
| Conclusion | 17 | ||
| Part III: Initial Assessment and Resuscitation | 57 | ||
| Airway Management:What Every Trauma Surgeon Should Know,From Intubation to Cricothyroidotomy | 57 | ||
| Airway anatomy | 57 | ||
| Assessing the airway | 63 | ||
| Controlling the airway | 63 | ||
| Documentation of proper endotracheal tube placement | 64 | ||
| Combitube | 64 | ||
| Endotracheal intubation | 65 | ||
| Nasal Intubation | 65 | ||
| Orotracheal Intubation | 65 | ||
| Adjuncts to Orotracheal Intubation | 67 | ||
| Surgical airway | 68 | ||
| Needle Cricothyroidotomy | 68 | ||
| Part IV: Head and Central Nervous System Injuries | 127 | ||
| Traumatic Brain Injury:Pathophysiology, Clinical Diagnosis, and Prehospital and Emergency Center Care | 127 | ||
| Incidence | 127 | ||
| Mechanism of injury | 127 | ||
| Subdural Hematoma | 127 | ||
| Epidural Hematoma | 127 | ||
| Subarachnoid Hemorrhage | 128 | ||
| Parenchymal Lesions | 128 | ||
| Ischemia | 128 | ||
| Diffuse Axonal Injury | 129 | ||
| Cellular and Molecular Factors | 129 | ||
| Clinical diagnosis | 129 | ||
| Clinical Examination | 129 | ||
| Serum Markers | 129 | ||
| Initial clinical interventions: prehospital and emergency center care | 129 | ||
| Airway | 130 | ||
| Breathing | 130 | ||
| Circulation | 130 | ||
| Imaging modalities: what, when, and why? | 130 | ||
| Computed Tomography Scanning | 130 | ||
| Magnetic Resonance Imaging | 130 | ||
| Angiography | 131 | ||
| Injury grading | 131 | ||
| Glasgow Coma Scale | 131 | ||
| Marshall Computed Tomography Scale | 131 | ||
| Abbreviated Injury Scale | 131 | ||
| Other Classification Schemes | 132 | ||
| Mild and Moderate Traumatic Brain Injury | 132 | ||
| Conclusions and algorithm | 132 | ||
| Traumatic Brain Injury:Imaging, Operative and Nonoperative Care, and Complications | 133 | ||
| Suggested Readings | 132.e1 | ||
| Traumatic Brain Injury: Imaging, Operative and Nonoperative Care, and Complications | 133 | ||
| Surgical management | 133 | ||
| Positioning | 133 | ||
| Bone Flap | 133 | ||
| Brain Swelling | 133 | ||
| Epidural Hematomas | 134 | ||
| Intraparenchymal Lesions | 134 | ||
| Intracranial Pressure Monitoring | 134 | ||
| Coagulopathy | 134 | ||
| Summary | 134 | ||
| Nonoperative management | 134 | ||
| Location of Care | 134 | ||
| Secondary Insults | 134 | ||
| Ventilator Weaning and Tracheostomy | 135 | ||
| Sedation | 135 | ||
| Cerebral Monitoring | 135 | ||
| Nutrition | 135 | ||
| Fluids and Electrolytes | 135 | ||
| Physical, Occupational, and Speech Therapy | 135 | ||
| Fever | 135 | ||
| Deep Venous Thrombosis | 135 | ||
| Transfusion Thresholds | 136 | ||
| Treatment of Intracranial Hypertension | 136 | ||
| Computed Tomography Scanning | 136 | ||
| Sedation and Paralysis | 136 | ||
| Cerebrospinal Fluid Drainage | 136 | ||
| Osmotic Diuretics | 136 | ||
| Hyperventilation | 136 | ||
| Barbiturate Coma | 136 | ||
| Decompressive Craniectomy | 136 | ||
| Hypothermia | 137 | ||
| Individualization of Treatment | 138 | ||
| Failure of Intracranial Pressure Prophylaxis | 138 | ||
| Guidelines | 138 | ||
| Failure of Clinical Trials | 138 | ||
| Morbidity and complications | 138 | ||
| Mortality | 138 | ||
| Penetrating Brain Injury | 139 | ||
| Conclusions and algorithm | 139 | ||
| Key Points | 140 | ||
| Suggested Readings | 140.e1 | ||
| Spine: Spinal Cord Injury,Blunt and Penetrating,Neurogenic and Spinal Shock | 140 | ||
| Incidence | 140 | ||
| Anatomy and biomechanics | 140 | ||
| Spinal Anatomy | 140 | ||
| Biomechanics of the Spine | 141 | ||
| Mechanism of injury | 141 | ||
| Penetrating Spinal Cord Injury | 142 | ||
| Blunt Spinal Cord Injury | 142 | ||
| Severity/grading of spinal cord injuries | 142 | ||
| Neurologic and Functional Outcome Scales | 142 | ||
| Spinal Cord Syndromes | 143 | ||
| Diagnosis | 144 | ||
| Management of acute spinal cord injury | 145 | ||
| Prehospital Care | 145 | ||
| Acute Emergency Department Evaluation/Management | 145 | ||
| Surgical Intervention | 146 | ||
| Thoracolumbar Fractures | 147 | ||
| Optimal Timing of Surgical Intervention in Spinal Cord Injuries | 147 | ||
| Penetrating Spinal Cord Injuries | 147 | ||
| Nonoperative Acute Interventions | 147 | ||
| Pharmacotherapy and Spinal Cord Injury | 147 | ||
| Institution of Blood Pressure Parameters | 147 | ||
| Subacute Management of Spinal Cord Injury | 150 | ||
| Morbidity and complications management in spinal cord injury | 150 | ||
| Neurogenic Shock | 150 | ||
| Spinal Shock | 150 | ||
| Pulmonary Complications | 150 | ||
| Thromboembolism | 151 | ||
| Genitourinary Complications | 151 | ||
| Gastrointestinal Complications | 151 | ||
| Skin Care | 151 | ||
| Posttraumatic Syringomyelia | 151 | ||
| Mortality | 152 | ||
| Conclusion | 152 | ||
| Suggested readings | 152.e1 | ||
| Part V: Maxillofacial and Ocular Injuries | 153 | ||
| Maxillofacial Trauma | 153 | ||
| Airway and breathing | 153 | ||
| Circulation and control of hemorrhage | 153 | ||
| Epistaxis | 153 | ||
| History and physical examination | 154 | ||
| Radiographs | 154 | ||
| Soft tissue injuries | 154 | ||
| Local Anesthesia | 154 | ||
| Antibiotics | 154 | ||
| Abrasions | 154 | ||
| General Concepts for Laceration Repair | 154 | ||
| Scalp Laceration | 154 | ||
| Intraoral Injury | 154 | ||
| Tongue Laceration | 154 | ||
| Lip Laceration | 154 | ||
| Nasal Laceration | 155 | ||
| Ear Laceration | 155 | ||
| Orbital Laceration | 155 | ||
| Parotid Gland Injury | 155 | ||
| Facial Nerve Injury | 155 | ||
| Facial fractures | 155 | ||
| Nasal Bone Fractures | 155 | ||
| Zygomatic Fractures | 156 | ||
| Orbital Fractures | 156 | ||
| Mandibular Fractures | 158 | ||
| Le Fort Fractures | 159 | ||
| Frontal Sinus Fractures | 160 | ||
| Naso-Orbital-Ethmoid Fractures | 161 | ||
| Conclusions | 162 | ||
| Suggested Readings | 162.e1 | ||
| Trauma to the Eye and Orbit | 162 | ||
| Incidence | 163 | ||
| Mechanism of injury | 165 | ||
| Diagnosis | 166 | ||
| Orbital Trauma | 166 | ||
| Ocular Trauma | 168 | ||
| Anatomic location of injury and injury grading-ocular trauma classification group | 172 | ||
| Medical and surgical management | 173 | ||
| Trauma to the Orbit | 173 | ||
| Conclusions and algorithm | 176 | ||
| Suggested Readings | 177.e1 | ||
| Part VI: Neck Injuries | 179 | ||
| Penetrating Neck Injuries: Diagnosis and Current Management | 179 | ||
| Anatomy of the neck | 179 | ||
| Initial evaluation | 179 | ||
| Aerodigestive injury | 179 | ||
| Soft tissue injury | 181 | ||
| Thoracic duct injury | 181 | ||
| Vascular injury in the neck | 181 | ||
| Treatment of carotid artery injuries | 184 | ||
| Conclusion | 185 | ||
| Suggested Readings | 185.e1 | ||
| Blunt Cerebrovascular Injuries | 185 | ||
| Signs and symptoms | 185 | ||
| Mechanism and patterns of injury | 185 | ||
| Diagnostic imaging | 186 | ||
| Injury grading scale | 187 | ||
| Incidence of blunt cerebrovascular injuries | 187 | ||
| Antithrombotic treatment | 188 | ||
| Role of endovascular stents | 191 | ||
| Long-term follow-up and outcome | 191 | ||
| Conclusions | 191 | ||
| Suggested Readings | 191.e1 | ||
| Tracheal, Laryngeal, and Oropharyngeal Injuries | 192 | ||
| Pharyngeal injury | 195 | ||
| Incidence | 195 | ||
| Mechanism of Injury | 195 | ||
| Diagnosis | 195 | ||
| Larynx | 195 | ||
| Surgical Anatomy | 195 | ||
| Laryngeal Injury | 196 | ||
| Incidence | 196 | ||
| Mechanism of Injury | 196 | ||
| Diagnosis | 196 | ||
| Treatment | 196 | ||
| Trachea | 198 | ||
| Surgical Anatomy | 198 | ||
| Tracheal Injury | 198 | ||
| Incidence | 198 | ||
| Mechanism of Injury | 199 | ||
| Cervical Trachea | 199 | ||
| Intrathoracic Tracheal Injury | 200 | ||
| Diagnosis | 200 | ||
| Surgical management | 200 | ||
| Nonoperative Management | 200 | ||
| Nonoperative Case Presentation | 200 | ||
| Operative Management | 201 | ||
| Morbidity | 202 | ||
| Early Complications | 202 | ||
| Late Complications | 203 | ||
| Other Potentially Life-Threatening Complications | 203 | ||
| Mortality | 204 | ||
| Anatomy of upper airway | 193 | ||
| Oral Cavity | 193 | ||
| Boundaries | 193 | ||
| Contents | 193 | ||
| Pharynx | 193 | ||
| Surgical Anatomy | 193 | ||
| Suggested Readings | 204.e1 | ||
| Part VII: Thoracic Injuries | 205 | ||
| Pertinent Surgical anatomy of the Thorax and Mediastinum | 205 | ||
| Pericardium | 212 | ||
| Subxiphoid Space | 213 | ||
| Heart | 214 | ||
| Body Surface Markings for the Heart | 214 | ||
| External Features | 214 | ||
| Coronary Arteries and Veins | 218 | ||
| Conduction System | 218 | ||
| Internal Features of Heart Chambers | 219 | ||
| Pulmonary Artery and Swan-Ganz Catheter Placement | 221 | ||
| Hilum of the lung | 222 | ||
| Right Hilum | 222 | ||
| Left Hilum | 226 | ||
| Lung anatomy | 226 | ||
| Aorta, trachea, esophagus, and thoracic duct | 226 | ||
| Aorta | 226 | ||
| Trachea | 227 | ||
| Esophagus | 228 | ||
| Thoracic Duct | 228 | ||
| Chest wall | 205 | ||
| Muscles of the chest wall | 207 | ||
| Intercostal space | 208 | ||
| Pleural space | 209 | ||
| Diaphragm | 209 | ||
| Suggested Readings | 228.e1 | ||
| Thoracic Wall Injuries:Ribs, Sternal, and Scapular Fractures; Hemothoraces and Pneumothoraces | 229 | ||
| Incidence | 229 | ||
| Mechanism of injury | 229 | ||
| Diagnosis | 229 | ||
| Physical Examination | 229 | ||
| Radiographic Studies | 230 | ||
| American association for the surgery of trauma-organ injury scale grading | 232 | ||
| Management of specific injuries of the chest wall | 233 | ||
| Chest Wall Defects | 233 | ||
| Rib Fractures and Flail Chest | 233 | ||
| Narcotics | 233 | ||
| Regional Anesthesia | 233 | ||
| Operative Fixation of Ribs | 234 | ||
| Pneumothorax and Hemothorax | 234 | ||
| Tube Thoracostomy: Technique and Management | 235 | ||
| Sternal Fractures | 235 | ||
| Scapular Fractures | 236 | ||
| Scapulothoracic Dissociation | 236 | ||
| Clavicular Fractures | 236 | ||
| Complications of hemopneumothorax | 236 | ||
| Empyema | 236 | ||
| Pneumatocele | 237 | ||
| Persistent Air Leaks and Bronchopleural Fistula | 237 | ||
| Complications of Bony Injuries | 237 | ||
| Conclusions | 237 | ||
| Diagnostic and Therapeutic Roles of Bronchoscopy and Video Assisted Thoracoscopy in the Management of Thoracic Trauma | 238 | ||
| Incidence | 238 | ||
| Diagnostic and therapeutic roles of video-assisted thoracoscopic surgery | 238 | ||
| Indications and Patient Selection | 238 | ||
| Diaphragmatic Injuries | 239 | ||
| Retained Thoracic Collection | 239 | ||
| Persistent Hemorrhage | 240 | ||
| Persistent Pneumothorax | 240 | ||
| Other Indications and Applications | 240 | ||
| Surgical Approach | 240 | ||
| Morbidity and Complication Management | 240 | ||
| Diagnostic and therapeutic role of bronchoscopy | 240 | ||
| Basic Technique of Flexible Fiberoptic Bronchoscopy | 241 | ||
| Preparation | 241 | ||
| Technique | 241 | ||
| Monitoring | 241 | ||
| Complications of Bronchoscopy | 241 | ||
| Diagnostic Role of Flexible Fiberoptic Bronchoscopy | 241 | ||
| Acute Trauma | 241 | ||
| Tracheobronchial Injury | 241 | ||
| Acute or Late Onset Bleeding Within the Tracheobronchial Tree | 242 | ||
| Inhalational Injury | 242 | ||
| Ventilator-Associated Pneumonia | 242 | ||
| Stricture | 243 | ||
| Therapeutic Role of Flexible Fiberoptic Bronchoscopy | 243 | ||
| Control of Acute or Late-Onset Hemoptysis | 243 | ||
| Stent Repair of Acute Airway Trauma | 243 | ||
| Removal of Foreign Body | 243 | ||
| Toilet for Pulmonary Collapse, Massive Secretions, and Aspiration | 243 | ||
| Percutaneous Tracheostomy | 244 | ||
| Management of Bronchopleural Fistula | 244 | ||
| Dilatation/Laser Therapy of Tracheobronchial Strictures | 244 | ||
| Drainage of Lung Abscess | 244 | ||
| Conclusion | 244 | ||
| Suggested Readings | 244.e1 | ||
| Pulmonary Contusionand Flail Chest | 245 | ||
| Incidence | 245 | ||
| Mechanisms of injury | 245 | ||
| Physical Mechanisms of Injury | 245 | ||
| Pathophysiology | 245 | ||
| Shunting and Hypoxemia | 246 | ||
| Increased Work of Breathing and Ventilatory Failure | 246 | ||
| Inflammatory Lung Injury | 246 | ||
| Extravascular Lung Water | 247 | ||
| Diagnosis | 247 | ||
| Physical Examination | 247 | ||
| Chest Radiographs | 247 | ||
| Chest Computed Tomography | 248 | ||
| Physiologic Studies | 249 | ||
| Anatomic location of injury and injury grading | 249 | ||
| Management | 249 | ||
| Immediate Management | 249 | ||
| Intensive Care Unit Management | 251 | ||
| General Principles of Ventilator Management | 251 | ||
| Ventilatory Support | 251 | ||
| Oxygenation Support | 251 | ||
| Pain Management | 252 | ||
| Steroids | 252 | ||
| Tracheostomy | 252 | ||
| Operative Stabilization of Flail Chest | 252 | ||
| Mortality | 253 | ||
| Conclusions | 253 | ||
| Suggested Readings | 254.e1 | ||
| Operative Treatment of Chest Wall Injury | 254 | ||
| Indications for operative therapy | 254 | ||
| Anatomy and Incisions | 254 | ||
| Operative Technique | 255 | ||
| Outcomes | 255 | ||
| Sternal fractures | 256 | ||
| Conclusions | 256 | ||
| Suggested Readings | 257.e1 | ||
| Tracheal and Tracheobronchial Tree Injuries | 257 | ||
| Incidence and mechanisms of injury | 257 | ||
| Diagnosis | 257 | ||
| Presentation | 257 | ||
| Evaluation | 258 | ||
| Management | 258 | ||
| Initial Management | 258 | ||
| Operative Management | 258 | ||
| Outcomes | 259 | ||
| Suggested Readings | 260.e1 | ||
| Operative Management of Pulmonary Injuries: Lung-Sparing and Formal Resections | 260 | ||
| Incidence | 261 | ||
| Etiology | 262 | ||
| Classification | 262 | ||
| Diagnosis | 262 | ||
| Physical Examination | 262 | ||
| Adjunctive Diagnostic Modalities | 263 | ||
| Noninvasive Diagnostic Modalities | 263 | ||
| Trauma Ultrasound | 263 | ||
| Chest Radiograph | 263 | ||
| Computed Tomography | 263 | ||
| Electrocardiogram | 263 | ||
| Invasive Diagnostic Modalities | 263 | ||
| Chest Tubes | 263 | ||
| Associated injuries | 264 | ||
| Anatomic location of injury | 264 | ||
| Management | 264 | ||
| Surgical Decisions | 265 | ||
| Operative Management | 265 | ||
| Emergency Department Thoracotomy | 265 | ||
| Effects of Pulmonary Hilar Cross-Clamping | 265 | ||
| Part VIII: Abdominal Injuries | 307 | ||
| Diaphragmatic Injury | 307 | ||
| Anatomy and physiology | 307 | ||
| Incidence | 307 | ||
| Mechanism and location of injury | 307 | ||
| Severity of injury | 308 | ||
| Diagnosis | 309 | ||
| Management | 312 | ||
| Mortality | 313 | ||
| Morbidity | 313 | ||
| Complicated diaphragmatic repair with thoracic injury | 313 | ||
| Combined chest wall and abdominal defect with diaphragmatic rupture | 314 | ||
| Suggested Readings | 316.e1 | ||
| Surgical Anatomy of the Abdomen and Retroperitoneum | 316 | ||
| Making the incision | 316 | ||
| Exploring the abdomen | 317 | ||
| Exploring the retroperitoneum | 318 | ||
| Future challenges | 321 | ||
| Summary | 322 | ||
| Suggested Readings | 322.e1 | ||
| Diagnostic Peritoneallavage and Laparoscopyin The Evaluation of Abdominal Trauma | 323 | ||
| Diagnostic peritoneal lavage | 323 | ||
| Diagnostic laparoscopy | 324 | ||
| Suggested Readings | 325.e1 | ||
| Nonoperative Management of Blunt and Penetrating Abdominal Injuries | 326 | ||
| Blunt abdominal injury | 326 | ||
| Key Surgical Therapy Points | 326 | ||
| Introduction | 326 | ||
| Incidence | 326 | ||
| Mechanism of Injury | 326 | ||
| Diagnosis | 326 | ||
| Anatomic Location of Injury and AAST-OIS Grading | 327 | ||
| Management | 328 | ||
| Spleen and Liver | 329 | ||
| Kidney | 329 | ||
| Duodenum and Pancreas | 330 | ||
| Role of Angiographic Interventions | 330 | ||
| Morbidity and Complications Management | 330 | ||
| Mortality | 331 | ||
| Conclusions | 332 | ||
| Penetrating abdominal injury | 332 | ||
| Key Surgical Therapy Points | 332 | ||
| Introduction | 332 | ||
| Incidence | 332 | ||
| Mechanism of Injury | 332 | ||
| Diagnosis | 333 | ||
| Anatomic Location of Injury and AAST-OIS Grading | 334 | ||
| Management | 334 | ||
| Morbidity and Complications Management | 335 | ||
| Mortality | 335 | ||
| Conclusions and Algorithm | 335 | ||
| Suggested Readings | 335.e1 | ||
| Gastric Injuries | 336 | ||
| Incidence | 336 | ||
| Mechanism of injury | 336 | ||
| Diagnosis | 337 | ||
| Surgical management | 337 | ||
| Mortality | 337 | ||
| Morbidity | 338 | ||
| Conclusion | 338 | ||
| Suggested Readings | 338.e1 | ||
| Small Bowel Injury | 339 | ||
| Incidence | 339 | ||
| Mechanism of injury | 339 | ||
| Diagnosis | 340 | ||
| Injury grading | 342 | ||
| Surgical management | 342 | ||
| Complications | 345 | ||
| Mortality | 345 | ||
| Conclusions | 345 | ||
| Suggested Readings | 346.e1 | ||
| Duodenal Injuries | 346 | ||
| Determinants of outcome | 346 | ||
| Anatomy and physiology | 346 | ||
| Diagnostic adjuvants | 347 | ||
| Treatment | 347 | ||
| Duodenal hematoma | 351 | ||
| Part IX: Special Issues in Major Torso Trauma | 415 | ||
| Current Concepts in the Diagnosis and Management of Hemorrhagic Shock | 415 | ||
| Epidemiology of severe hemorrhagic shock | 415 | ||
| The clinical perspective: changing concepts on resuscitation | 415 | ||
| The Discrepancies between the Clinical Syndrome of Shock and the Animal Models Used to Study It | 416 | ||
| Diagnosis of shock | 416 | ||
| Assessment of Tissue Perfusion | 417 | ||
| Management of shock | 417 | ||
| Vascular Access for Patients with Severe Hemorrhage | 417 | ||
| Adjunct measures to control hemorrhage | 418 | ||
| Local Hemorrhage Control | 418 | ||
| Systemic Hemorrhage Control | 418 | ||
| Tranexamic Acid | 418 | ||
| Factor VIIa | 418 | ||
| Prothrombin Complex Concentrates | 418 | ||
| Timing and volume of resuscitation fluid therapy | 419 | ||
| Type of Fluid | 419 | ||
| Crystalloids | 419 | ||
| Colloids | 419 | ||
| Albumin | 419 | ||
| Hextend | 419 | ||
| Hypertonic Saline | 420 | ||
| Red Blood Cell Transfusion | 420 | ||
| Blood Substitutes | 420 | ||
| Pharmacotherapy | 421 | ||
| Vasopressin | 421 | ||
| New therapeutic possibilities: hypothermia and hemorrhagic shock | 421 | ||
| Summary | 421 | ||
| Suggested Readings | 421.e1 | ||
| The syndrome of Exsanguination: Reliable Models to Indicate Damage Control | 422 | ||
| History | 422 | ||
| Metabolic failure | 422 | ||
| Models for damage control | 422 | ||
| Patient selection | 423 | ||
| Technique of damage control | 424 | ||
| Conclusions | 425 | ||
| Suggested Readings | 425.e1 | ||
| Damage Control Resuscitation: An Evidence-Based Report | 425 | ||
| Evidence classification | 426 | ||
| Evidence report | 426 | ||
| Ratios of Fresh Frozen Plasma to Packed Red Blood Cells | 426 | ||
| Ratios of Platelets and Packed Red Blood Cells | 426 | ||
| Quantity of Units Transfused | 426 | ||
| Utilization of Platelets, Fibrinogen, and Antifribrinolytics | 427 | ||
| Timing of Transfusions | 427 | ||
| Establishment and Effectiveness of Massive Transfusion Protocols | 427 | ||
| Transfusion Complications | 428 | ||
| Mortality | 428 | ||
| Morbidity | 428 | ||
| Survival Bias | 429 | ||
| Recommendations | 429 | ||
| Stratification Scheme and Level Definitions | 429 | ||
| Level I Recommendations | 429 | ||
| Level II Recommendations | 429 | ||
| Level III Recommendations | 430 | ||
| Conclusion | 430 | ||
| Suggested Readings | 430.e1 | ||
| Surgical Techniques for Thoracic, Abdominal, Pelvic, and Extremity Damage Control | 430 | ||
| Introduction | 430 | ||
| The Lethal Triad | 430 | ||
| Initial Resuscitation Concerns | 431 | ||
| Phase I: the damage control operation | 431 | ||
| The Damage Control Laparotomy | 431 | ||
| The Damage Control Thoracotomy | 432 | ||
| Damage Control Orthopedics | 433 | ||
| Phase 2: resuscitation in the intensive care unit | 433 | ||
| Phase 3: definitive operative management | 434 | ||
| Complications following damage control surgery | 434 | ||
| Immediate Complications | 434 | ||
| Delayed Complications | 435 | ||
| Summary | 435 | ||
| Suggested Readings | 435.e1 | ||
| Abdominal Compartment Syndrome, Damage Control, and the Open Abdomen | 435 | ||
| Abdominal compartment syndrome | 435 | ||
| Damage control | 437 | ||
| Temporary Abdominal Closure | 439 | ||
| Definitive Reconstruction and Closure (DC3) | 440 | ||
| Resuscitation | 440 | ||
| Restoration | 440 | ||
| Reconstruction | 441 | ||
| Special considerations: nutrition support | 443 | ||
| Outcomes and complications of open abdomen | 444 | ||
| Conclusion | 446 | ||
| Acknowledgment | 446 | ||
| Suggested readings | 446.e1 | ||
| Torso Trauma on the Modern Battlefield | 446 | ||
| Introduction to combat torso trauma | 446 | ||
| Incidence and epidemiology of combat torso trauma | 446 | ||
| Noncompressible torso hemorrhage: defining the problem | 447 | ||
| Mechanisms of combat torso injuries | 447 | ||
| Initial evaluation | 448 | ||
| Operative intervention | 448 | ||
| Choice of Incision | 449 | ||
| Damage Control in the Chest | 450 | ||
| Operative Lung Injury | 450 | ||
| Large Hemothorax | 451 | ||
| Multiple Truncal Fragment Wounds | 451 | ||
| Abdominal Solid Organ Injury | 451 | ||
| Bowel Injuries | 452 | ||
| Massive Abdominal Wall and Perineal/Pelvic Wounds | 453 | ||
| Future directions | 453 | ||
| Suggested Readings | 455.e1 | ||
| Part X: Peripheral Vascular Injury | 457 | ||
| Vascular Anatomy of the Extremities | 457 | ||
| Vascular anatomy of the upper extremity | 457 | ||
| Axillary Artery and Vein | 457 | ||
| Brachial Artery and Veins | 457 | ||
| Radial and Ulnar Arteries and Veins | 458 | ||
| Vascular anatomy of the lower extremity | 458 | ||
| The Femoral Arteries and Veins | 458 | ||
| Popliteal Artery and Vein | 458 | ||
| Tibial Arteries and Veins | 458 | ||
| Saphenous Veins | 458 | ||
| Suggested Readings | 458.e1 | ||
| Diagnosis of Vascular Trauma | 459 | ||
| Diagnosis | 459 | ||
| History | 459 | ||
| Physical Examination | 459 | ||
| Hard and soft signs of vascular injury | 459 | ||
| Additional ancillary tests | 460 | ||
| Specific areas of injury | 461 | ||
| Suggested Readings | 462.e1 | ||
| Penetrating Carotid Artery: Uncommon Complex and Lethal Injuries | 463 | ||
| Historical perspective | 463 | ||
| Incidence and mechanism of injury | 463 | ||
| Anatomy | 463 | ||
| Diagnosis | 464 | ||
| Anatomic location of injury | 465 | ||
| Surgical management | 465 | ||
| Outcomes and mortality | 469 | ||
| Morbidity | 469 | ||
| Conclusions | 469 | ||
| Suggested Readings | 469.e1 | ||
| Subclavian Vessel Injuries: Difficult Anatomy and Difficult Territory | 469 | ||
| Historical perspective | 469 | ||
| Anatomy | 470 | ||
| Incidence | 471 | ||
| Clinical presentation | 471 | ||
| Diagnosis | 472 | ||
| Surgical management | 472 | ||
| Morbidity | 475 | ||
| Outcomes and mortality | 475 | ||
| Conclusions | 476 | ||
| Suggested Readings | 476.e1 | ||
| Operative Exposure and Management of Axillary Vessel Injuries | 476 | ||
| Historical perspective | 476 | ||
| Incidence and mechanism of injury | 476 | ||
| Anatomy | 477 | ||
| Diagnosis | 477 | ||
| Surgical management | 478 | ||
| Basic Principles for the Management of Vascular Injuries | 478 | ||
| Specific Management of Axillary Vessels Injuries | 479 | ||
| Outcomes and mortality | 480 | ||
| Conclusions | 481 | ||
| Suggested Readings | 481.e1 | ||
| Brachial Vessel Injuries: High Morbidity and Low Mortality Injuries | 481 | ||
| Historical perspective | 481 | ||
| Incidence and mechanism of injury | 481 | ||
| Anatomy | 483 | ||
| Diagnosis | 483 | ||
| Anatomic location of injury | 483 | ||
| Surgical management | 483 | ||
| Outcomes and mortality | 485 | ||
| Morbidity | 486 | ||
| Conclusions | 487 | ||
| Suggested Readings | 487.e1 | ||
| Iliac Vessel Injuries: Difficult Injuries and Difficult Management Problems | 487 | ||
| Historical perspective | 487 | ||
| Incidence | 488 | ||
| Anatomy | 489 | ||
| Clinical pesentation | 489 | ||
| Diagnosis | 490 | ||
| Surgical management | 490 | ||
| Morbidity and mortality | 493 | ||
| Conclusions | 494 | ||
| Suggested Readings | 494.e1 | ||
| Femoral Vessel Injuries: High Mortality and Low Morbidity Injuries | 494 | ||
| Anatomy | 494 | ||
| Incidence | 495 | ||
| Historical perspective and wartime experiences | 495 | ||
| World War I | 495 | ||
| World War II | 495 | ||
| Korean Conflict | 495 | ||
| Vietnam Conflict | 496 | ||
| Iraq and Afghanistan | 496 | ||
| Mechanism of injury | 496 | ||
| Civilian epidemiology | 496 | ||
| Clinical presentation | 496 | ||
| Diagnosis | 497 | ||
| Surgical management | 497 | ||
| Primary Repair | 498 | ||
| Grafts | 501 | ||
| Fasciotomies and Shunting | 502 | ||
| Venous injuries | 502 | ||
| Outcomes and mortality | 503 | ||
| Conclusions | 504 | ||
| Suggested Readings | 504.e1 | ||
| Popliteal Vessel Injuries: Complex Anatomy and High Amputation Rates | 504 | ||
| Historical perspective | 504 | ||
| Anatomy | 505 | ||
| Incidence | 506 | ||
| Clinical presentation | 506 | ||
| Diagnosis | 507 | ||
| Management | 507 | ||
| Morbidity | 516 | ||
| Outcomes and mortality | 517 | ||
| Conclusions | 518 | ||
| Suggested Readings | 518.e1 | ||
| Temporary Vascular Shunts | 518 | ||
| Definition | 518 | ||
| Historical perspective | 518 | ||
| Indications for temporary vascular shunts | 518 | ||
| Available shunts | 519 | ||
| Operative technique | 520 | ||
| Outcomes | 520 | ||
| Practical points in conclusion | 521 | ||
| Suggested Readings | 521.e1 | ||
| Part XI: Musculoskeletal and Peripheral Central Nervous System Injuries | 523 | ||
| Upper Extremity Fractures: Orthopedic Management | 523 | ||
| Open fractures | 523 | ||
| Dislocations | 523 | ||
| Gunshot wounds | 524 | ||
| Compartment syndrome | 524 | ||
| Imaging studies | 524 | ||
| Injuries to the shoulder girdle and humerus | 525 | ||
| Sternoclavicular Dislocation | 525 | ||
| Clavicle Fractures | 526 | ||
| Acromioclavicular Dislocation (Separated Shoulder) | 527 | ||
| Scapular Fractures | 527 | ||
| Scapulothoracic Dissociation | 528 | ||
| Glenohumeral Dislocation | 528 | ||
| Proximal Humerus Fractures | 528 | ||
| Humeral Shaft Fractures | 529 | ||
| Elbow | 531 | ||
| Distal Humerus Fractures | 531 | ||
| Elbow Dislocation | 531 | ||
| Radial Head Fractures | 532 | ||
| Coronoid Fractures | 532 | ||
| Olecranon Fractures | 534 | ||
| Forearm | 534 | ||
| Monteggia Fracture | 534 | ||
| Radial and Ulnar Shaft Fractures | 535 | ||
| Galeazzi Fractures | 535 | ||
| Suggested Readings | 535.e1 | ||
| Lower Extremity and Degloving Injury | 535 | ||
| Radiologic evaluation | 535 | ||
| Fractures | 535 | ||
| Early care of musculoskeletal injuries | 536 | ||
| Open fractures | 536 | ||
| Identification and Classification | 536 | ||
| Management | 536 | ||
| Immediate Wound Care | 536 | ||
| Irrigation and Débridement | 537 | ||
| Reduction and Fixation | 537 | ||
| Wound Coverage | 537 | ||
| Compartment syndromes | 538 | ||
| Degloving injuries | 538 | ||
| Mangled extremities: delayed amputation | 539 | ||
| Suggested Readings | 539.e1 | ||
| Cervical, Thoracic, and Lumbar Fractures | 540 | ||
| Spinal cord syndromes | 540 | ||
| Steroids in spinal cord injuries | 540 | ||
| Cervical spine injuries | 540 | ||
| Pertinent Anatomy of Cervical Spine | 540 | ||
| Patterns and Management of Cervical Spine Injuries | 540 | ||
| Occipital Condyle Fractures | 540 | ||
| Occipitocervical Dissociation (Atlantoaxial Dissociation) | 541 | ||
| Atlas Fracture | 541 | ||
| Dens Fractures | 541 | ||
| Hangmans Fracture | 541 | ||
| Subaxial Spine Fractures | 541 | ||
| Thoracic and lumbar spine injuries | 542 | ||
| Pertinent Anatomy of the Thoracic and Lumbar Spine | 542 | ||
| Thoracic and Lumbar Fractures | 543 | ||
| Suggested Readings | 543.e1 | ||
| Pelvic Fractures | 544 | ||
| Anatomy | 544 | ||
| Imaging | 544 | ||
| Classification | 544 | ||
| Initial assessment | 544 | ||
| Initial treatment | 545 | ||
| Definitive treatment | 548 | ||
| Outcomes | 549 | ||
| Summary | 549 | ||
| Suggested Readings | 549.e1 | ||
| Wrist and Handfractures: Orthopedicmanagement of Currenttherapy of Trauma and Surgical Critical Care | 550 | ||
| Scapulothoracic Dissociation and Degloving Injuries of the Extremities | 550 | ||
| Extremity Replantation: Indications and Timing | 550 | ||
| Wrist and Hand Fractures: Orthopedic Management of Current Therapy of Trauma and Surgical Critical Care | 550.e1 | ||
| Distal radius fracture | 550.e1 | ||
| Dislocations of the wrist | 550.e1 | ||
| Carpal fractures and ligament injuries | 550.e1 | ||
| Carpometacarpal joint injuries | 550.e3 | ||
| Metacarpal and phalangeal injuries | 550.e3 | ||
| Acute carpal tunnel syndrome | 550.e3 | ||
| Suggested Readings | 550.e3 | ||
| Scapulothoracic Dissociation And Degloving Injuries Of The Extremities | 550.e4 | ||
| Incidence | 550.e4 | ||
| Mechanism of Injury | 550.e4 | ||
| Diagnosis | 550.e4 | ||
| Injury Grading | 550.e5 | ||
| Management | 550.e5 | ||
| Morbidity and Complications | 550.e6 | ||
| Mortality | 550.e6 | ||
| Conclusions and Algorithm | 550.e6 | ||
| Suggested Readings | 550.e7 | ||
| Extremity Replantation:Indications And Timing | 550.e8 | ||
| History | 550.e8 | ||
| Microsurgical Centers | 550.e8 | ||
| Transportation | 550.e8 | ||
| Evaluation Of Theamputated Part | 550.e9 | ||
| Indications | 550.e9 | ||
| Contraindications | 550.e9 | ||
| Surgical Management | 550.e10 | ||
| Preparation of the Amputated Part | 550.e10 | ||
| Surgical Sequence | 550.e10 | ||
| Bone Shortening and Fixation | 550.e10 | ||
| Extensor Tendon Repair | 550.e11 | ||
| Flexor Tendon Repair | 550.e11 | ||
| Arterial Repair | 550.e11 | ||
| Venous Repair | 550.e11 | ||
| Nerve Repair | 550.e12 | ||
| Skin Coverage | 550.e12 | ||
| Postoperative Care | 550.e12 | ||
| Management of a Compromised Replant | 550.e13 | ||
| Replantation Of Variousother Parts | 550.e13 | ||
| Suggested Readings | 550.e13 | ||
| Special Techniques For The Management Of Complex Musculoskeletal Injuries: The Roles Of Fasciocutaneous And Myocutaneous Flaps | 551.e1 | ||
| Diagnosis | 551.e1 | ||
| Surgical Management | 551.e1 | ||
| Head and Neck | 551.e1 | ||
| Upper Extremity | 551.e1 | ||
| Chest and Trunk | 551.e2 | ||
| Abdominal Wall and Groin | 551.e4 | ||
| Lower Extremity | 551.e4 | ||
| Conclusion | 551.e6 | ||
| Suggested Readings | 551.e6 | ||
| Part XII: Special Issues and Situations in Trauma Management | 553 | ||
| Airway Management:What Every Surgeon Should Know About The Traumatic Airway(The Anesthesiologist’Sperspective) | 553 | ||
| American society of anesthesiologists difficult airway algorithm modification for trauma | 555 | ||
| Summary | 556 | ||
| Pediatric Trauma | 556 | ||
| Incidence of pediatric trauma | 556 | ||
| Mechanisms of pediatric trauma | 556 | ||
| Suggested Readings | 556.e1 | ||
| Initial assessment, stabilization, and management of the injured child | 557 | ||
| Airway Management | 557 | ||
| Vascular Access | 557 | ||
| Circulatory Management | 557 | ||
| Diagnostic Assessment | 558 | ||
| Management of specific injuries | 559 | ||
| Head and Central Nervous System Injury | 559 | ||
| Thoracic Injuries | 560 | ||
| Abdominal Injuries | 560 | ||
| Acknowledgment | 561 | ||
| Trauma in Pregnancy | 561 | ||
| Epidemiology | 561 | ||
| Suggested Readings | 561.e1 | ||
| Mechanism of injury | 562 | ||
| Blunt Trauma | 562 | ||
| Penetrating Trauma | 562 | ||
| Intimate Partner Violence | 562 | ||
| Physiologic alterations of pregnancy | 562 | ||
| Second Trimester | 562 | ||
| Third Trimester | 563 | ||
| Diagnosis | 563 | ||
| Primary Survey | 563 | ||
| Secondary Survey | 563 | ||
| Initial Evaluation of the Fetus | 564 | ||
| Exposure to Radiation from Diagnostic Radiographs | 564 | ||
| Surgical management | 564 | ||
| Blunt Trauma | 565 | ||
| Penetrating Trauma | 565 | ||
| Cesarean Section | 565 | ||
| Morbidity and complications management | 566 | ||
| Fetomaternal Hemorrhage | 566 | ||
| Premature Labor | 566 | ||
| Preeclampsia and Eclampsia | 566 | ||
| Placental Abruption | 566 | ||
| Amniotic Fluid Embolization | 566 | ||
| Venous Thromboembolism | 566 | ||
| Intraabdominal Infection | 566 | ||
| Mortality | 567 | ||
| Conclusions | 567 | ||
| Trauma in Our “Elders” | 567 | ||
| Physiologic changes | 567 | ||
| Suggested Readings | 567.e1 | ||
| Mechanism of injury | 568 | ||
| Outcomes | 569 | ||
| Management of specific organ injuries | 569 | ||
| Conclusions | 571 | ||
| Part XIII: Critical Care I: Management of Organ Failures and Techniques for Support | 607 | ||
| Cardiac Hemodynamics: The Pulmonary Artery Catheter and the Meaning of its Readings | 607 | ||
| History of controversy | 607 | ||
| Pulmonary artery catheter use and insertion: what it is and how it works | 608 | ||
| Insertion Tips and Guidelines | 609 | ||
| Interpretation: what does it measure and what does it mean? | 609 | ||
| Initial Warnings and Potential Measurement Problems | 609 | ||
| Pressure, Volume, and Work Measures | 610 | ||
| Goal-Directed Therapy Using Pulmonary Artery Catheter | 611 | ||
| Mixed Venous Saturation: Monitoring Tissue Metabolism | 612 | ||
| Right Ventricle End-Diastolic Pressure as Measure of Cardiac Index and Cardiac Function | 612 | ||
| Alternatives to the pulmonary artery catheter | 612 | ||
| Summary | 612 | ||
| Suggested Readings | 613.e1 | ||
| Oxygen Transport | 613 | ||
| Energy generation in the cell | 613 | ||
| Microcirculation and oxygen delivery | 614 | ||
| Hemoglobin, the Ultimate Oxygen Carrier | 614 | ||
| Heart as Oxygen Delivery Pump | 615 | ||
| Putting it all together: measuring cellular oxygen consumption and extraction in patients | 615 | ||
| Relationship of Oxygen Consumption and Oxygen Delivery during Pathologic States | 615 | ||
| Characteristic Oxygen Transport Variables in States of Shock | 616 | ||
| Hemorrhagic Shock | 616 | ||
| Cardiogenic Shock | 616 | ||
| Septic Shock | 616 | ||
| Neurogenic Shock | 616 | ||
| Conclusions | 616 | ||
| Suggested Readings | 616.e1 | ||
| Pharmacologic Support of Cardiac Failure | 616 | ||
| Pathophysiology | 616 | ||
| Treatment | 617 | ||
| Diuretics | 617 | ||
| Vasodilators | 617 | ||
| Inotropes and Vasopressors | 618 | ||
| Inotropic Agents | 618 | ||
| Vasopressors | 619 | ||
| Other Agents | 619 | ||
| Special circumstances | 619 | ||
| Heart Failure in Septic Shock | 619 | ||
| Right Ventricular Failure | 620 | ||
| Blunt Cardiac Injury | 620 | ||
| Summary | 620 | ||
| Suggested Readings | 620.e1 | ||
| Diagnosis and Management of Cardiac Dysrhythmias | 621 | ||
| Incidence and risk factors | 621 | ||
| Bradyarrhythmias | 621 | ||
| Sinus Node | 621 | ||
| Atrioventricular Node | 622 | ||
| Tachyarrhythmias | 623 | ||
| Sinus Tachycardia | 624 | ||
| Paroxysmal Supraventricular Tachycardia | 624 | ||
| Wolff-Parkinson-White Syndrome | 624 | ||
| Multifocal Atrial Tachycardia | 625 | ||
| Atrial Flutter | 625 | ||
| Atrial Fibrillation | 625 | ||
| Ventricular Tachyarrhythmias | 626 | ||
| Premature Ventricular Contractions | 627 | ||
| Monomorphic Ventricular Tachycardia | 627 | ||
| Polymorphic Ventricular Tachycardia | 627 | ||
| Conclusion | 628 | ||
| Suggested Readings | 628.e1 | ||
| Fundamentals of Mechanical Ventilation | 628 | ||
| Key points | 628 | ||
| Noninvasive ventilation | 628 | ||
| Contraindications to Noninvasive Ventilation | 629 | ||
| Complications of Noninvasive Ventilation | 629 | ||
| Pressure support ventilation | 630 | ||
| Heliox | 630 | ||
| Modes of mechanical ventilation | 630 | ||
| Assist-Control Ventilation | 630 | ||
| Synchronized Intermittent Mandatory Ventilation | 630 | ||
| Positive End-Expiratory Pressure | 630 | ||
| Ventilator \"Bundle | 631 | ||
| Routine Settings | 632 | ||
| Sedation | 632 | ||
| Monitoring | 632 | ||
| Blood Gases | 632 | ||
| Pulse Oximetry | 634 | ||
| Capnography | 634 | ||
| Invasive hemodynamic monitoring | 635 | ||
| Arterial Catheterization | 635 | ||
| Central Venous Pressure Monitoring | 635 | ||
| Pulmonary artery catheterization | 636 | ||
| Clinical use of the pulmonary artery catheter | 636 | ||
| Liberation from mechanical ventilation | 636 | ||
| Special airway considerations | 638 | ||
| Unplanned Extubation | 638 | ||
| Reintubation | 638 | ||
| Tracheostomy | 638 | ||
| Suggested Readings | 639.e1 | ||
| Advanced Techniques in Mechanical Ventilation | 639 | ||
| Key points | 639 | ||
| Impaired oxygenation following acute lung injury | 639 | ||
| Ventilator-Induced Lung Injury | 639 | ||
| Alternatives to conventional mechanical ventilation | 640 | ||
| Pressure-Controlled Ventilation | 640 | ||
| Open Lung Ventilation | 640 | ||
| Inverse-Ratio Ventilation | 641 | ||
| Airway Pressure Release Ventilation | 641 | ||
| Permissive Hypercapnia | 642 | ||
| Proportional Assist Ventilation | 642 | ||
| Adaptive Support Ventilation | 642 | ||
| Neutrally Adjusted Ventilator Assist | 642 | ||
| Mandatory Minute Ventilation | 643 | ||
| High-Frequency Oscillatory Ventilation | 643 | ||
| Pharmacotherapy | 643 | ||
| Surfactant Administration | 643 | ||
| Inhaled Nitric Oxide | 643 | ||
| Unconventional methods of ventilation | 643 | ||
| Extracorporeal Membrane Oxygenation | 643 | ||
| Prone Positioning | 644 | ||
| The future | 644 | ||
| Suggested Readings | 644.e1 | ||
| Management of Renal Failure: Renal Replacement Therapy and Dialysis | 644 | ||
| Incidence | 644 | ||
| Mechanism of injury/etiology | 645 | ||
| Diagnosis | 645 | ||
| Water and Fluid Homeostasis | 645 | ||
| Assessment of Renal Function | 645 | ||
| Creatinine Clearance | 645 | ||
| Urine Production and Output | 645 | ||
| Management of patients | 645 | ||
| Conservative Management | 645 | ||
| Nonpharmacologic Strategies for Acute Renal Failure Prevention | 646 | ||
| Fluids | 646 | ||
| Nephrotoxin Exposure | 646 | ||
| Pharmacologic Strategies for Acute Renal Failure Prevention | 646 | ||
| Loop Diuretics | 646 | ||
| N-Acetylcysteine | 646 | ||
| Indications for renal replacement therapy in acute renal failure | 646 | ||
| Volume Overload | 646 | ||
| Hyperkalemia | 646 | ||
| Metabolic Acidosis | 647 | ||
| Other Electrolyte Disturbances | 647 | ||
| Uremia | 647 | ||
| Azotemia | 647 | ||
| Timing of initiation of renal replacement therapy | 647 | ||
| Modalities for Renal Replacement Therapy in Acute Renal Failure | 647 | ||
| Principles of Renal Replacement Therapy | 647 | ||
| Classification of renal replacement therapies | 648 | ||
| Intermittent Hemodialysis | 648 | ||
| Continuous Renal Replacement Therapy | 648 | ||
| Advantages and Disadvantages | 649 | ||
| Intermittent Hemodialysis Versus Continuous Renal Replacement Therapy: Outcomes | 649 | ||
| Sustained Low-Efficiency Dialysis or Extended Daily Dialysis | 649 | ||
| Summary | 649 | ||
| Suggested Readings | 650.e1 | ||
| Management of Coagulation Disorders in the Surgical Intensive Care Unit | 650 | ||
| Incidence and mechanism of disease | 650 | ||
| Congenital Bleeding Disorders | 650 | ||
| Von Willebrand Disease | 650 | ||
| Hemophilia A | 650 | ||
| Hemophilia B | 650 | ||
| Acquired Bleeding Disorders | 651 | ||
| Coagulopathy of Hemorrhagic Shock | 651 | ||
| Hypothermia | 651 | ||
| Acidosis | 651 | ||
| Thrombocytopenia | 651 | ||
| Disseminated Intravascular Coagulation | 652 | ||
| Severe Sepsis | 652 | ||
| Traumatic Brain Injury | 652 | ||
| Vitamin K Deficiency | 652 | ||
| Anticoagulant Drugs | 652 | ||
| Cirrhosis and End-Stage Liver Disease | 653 | ||
| Renal Failure | 653 | ||
| Liver Injury | 653 | ||
| Diagnosis | 653 | ||
| Clinical Evaluation | 653 | ||
| Laboratory Tests of Coagulation | 655 | ||
| Management | 656 | ||
| Blood Product Transfusion | 656 | ||
| Fresh Frozen Plasma | 656 | ||
| Platelets | 656 | ||
| Cryoprecipitate | 656 | ||
| Reversal of Warfarin | 656 | ||
| Reversal of Heparin | 657 | ||
| Reversal of Novel Oral Anticoagulants | 657 | ||
| Recombinant Activated Factor VIIa | 657 | ||
| Conclusions | 658 | ||
| Suggested Readings | 658.e1 | ||
| Management of Endocrine Disorders in the Surgical Intensive Care Unit | 658 | ||
| Key surgical points | 658 | ||
| Brain problems: abnormalities in hypothalamic/pituitary response | 658 | ||
| Diabetes Insipidus | 658 | ||
| SIADH and Cerebral Salt Wasting | 659 | ||
| Abnormalities in thyroid response | 660 | ||
| Thyroid Excess | 660 | ||
| Thyroid Deficit | 660 | ||
| Sick Euthyroid Syndrome | 661 | ||
| Abnormalities of adrenal function | 661 | ||
| Pheochromocytoma | 661 | ||
| Adrenal Insufficiency | 662 | ||
| Problems with hyperglycemia | 662 | ||
| Other endocrine contributions: procalcitonin | 663 | ||
| Summary | 665 | ||
| Suggested Readings | 665.e1 | ||
| Transfusion: Management of Blood and Blood Products in Trauma | 665 | ||
| Incidence: who needs blood transfusion in trauma? | 665 | ||
| Massive transfusion | 665 | ||
| Identification of Trauma Patients Who Will Require Massive Transfusion | 668 | ||
| Blood transfusion components | 668 | ||
| Red Blood Cells | 668 | ||
| Fresh Frozen Plasma | 670 | ||
| Platelets | 670 | ||
| Cryoprecipitate | 670 | ||
| Fibrinogen Concentrate | 670 | ||
| Blood Component Therapy: Fresh Frozen Plasma, Platelets, and Cryoprecipitate | 671 | ||
| The Prospective Observational Multicenter Major Trauma Transfusion Study | 671 | ||
| The Pragmatic Randomized Optimal Platelets and Plasma Ratios Trial | 671 | ||
| Restrictive transfusion strategies in trauma | 671 | ||
| Risks of blood transfusion | 672 | ||
| Transfusion-Related Acute Lung Injury | 673 | ||
| Blood Transfusion and Postinjury Multiple-Organ Failure | 673 | ||
| Blood Transfusion and Systemic Inflammatory Response Syndrome/Mortality | 673 | ||
| Blood transfusion and mortality | 673 | ||
| Blood transfusion and infection | 674 | ||
| Potential mechanisms for transfusion-associated adverse outcome | 674 | ||
| Red Blood Cell Storage Lesion | 675 | ||
| Management of complications related to blood transfusion | 675 | ||
| Thrombocytopenia | 676 | ||
| Coagulation Factor Depletion | 676 | ||
| Hypocalcemia | 676 | ||
| Hypokalemia and Hyperkalemia | 677 | ||
| Acid-Base Disturbances | 677 | ||
| Hypothermia | 677 | ||
| Conclusions | 677 | ||
| Suggested Readings | 677.e1 | ||
| Part XIV: Critical Care II: Special issues and Treatments | 679 | ||
| Acute Respiratory Distress Syndrome | 679 | ||
| Definition, presentation, and clinical diagnosis | 679 | ||
| Epidemiology | 680 | ||
| Pathophysiology | 680 | ||
| Therapy and supportive measures | 680 | ||
| Fluid Resuscitation and Management | 680 | ||
| Noninvasive Mechanical Ventilation Versus Mechanical Ventilation | 681 | ||
| Mechanical Ventilation Techniques | 681 | ||
| Alternative Therapies | 682 | ||
| Conclusion | 682 | ||
| Part XV: Rehabilitation and Quality of Life After Trauma and Other Issues | 757 | ||
| Palliative Care in Thetrauma Intensivecare Unit | 757.e1 | ||
| What is palliative care in the intensive care unit? | 757.e1 | ||
| When to start palliative care in the intensive care unit | 757.e1 | ||
| Communication and shared decision making | 757.e2 | ||
| Withholding and withdrawal of life support | 757.e2 | ||
| Pain and symptom management | 757.e3 | ||
| Family and bereavement support | 757.e4 | ||
| Index | 759 | ||
| Inside Back Cover | ES3 |