By Andrew B. Peitzman MD FACS, Michael Rhodes MD FACS, C. William Schwab MD FACS, Donald M. Yealy MD, Timothy C. Fabian MD FACS

The completely up-to-date 3rd version of this renowned and widespread pocket reference courses the trauma staff via each element of sufferer care after damage and earlier than, in the course of, and after acute care surgery—from prehospital care, to resuscitation, remedy of particular organ accidents, priorities in extensive care, and administration of specified occasions. Designed for speedy, on-the-spot info retrieval, this handbook may be a staple reference in emergency departments and trauma centers.

Flow charts, algorithms, sequential lists, and tables all through facilitate speedy medical decision-making. greater than two hundred illustrations reveal particular accidents and methods. Appendices comprise organ damage scales, tetanus prophylaxis concepts, and regularly used forms.

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Extra resources for The Trauma Manual: Trauma and Acute Care Surgery (Lippincott Manual Series (Formerly known as the Spiral Manual Series))

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Pulmonary system ♦ Increases minute ventilation from hyperventilation and increased tidal volume. ♦ Produces angiotensin-converting enzyme. • Central nervous system ♦ First interprets physiologic responses to trauma, and then initiates the physiologic responses. ♦ Coordinates afferent stimuli into a multisystem response. ♦ Increases sympathetic nervous system activity. ♦ Governs neuroendocrine response. • Splanchnic system ♦ Decreases blood flow secondary to shunting of blood to preserve blood flow to the heart and brain.

Obstructive shock. Mechanical obstruction to cardiac function from either direct cardiac compression or obstruction of venous return (cardiac tamponade, tension pneumothorax) results in decreased peripheral perfusion. • Traumatic shock includes elements of the above mentioned causes of shock that may not be sufficient to induce hypoperfusion in isolation, but markedly impair peripheral perfusion when combined. Generally includes the sequelae of hypovolemia from blood loss and activation of proinflammatory mediators elaborated as a result of long bone or soft tissue injury.

Altered protein, glucose, and fat metabolism Energy requirements are increased following injury, with the magnitude of the additional energy need dependent on the severity of injury, magnitude of tissue destruction, and lean body mass of the patient. ♦ Protein loss is approximately 300 to 500 grams per day (g/day) of lean body mass, with visceral proteins spared at the expense of skeletal muscle proteins. ♦ Proteins are broken down to constituent amino acids that are catabolized to ammonia (forms urea) and precursors of the tricarboxylic cycle (TCA).

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