Table Of ContentTrauma Care Manual
Second edition
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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
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British Library Cataloguing in Publication Data
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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
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This edition is dedicated to Professor James M. Ryan.
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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
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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
