tailieunhanh - Ebook The washington manual of surgery (6/E): Part 2

Part 2 book “The washington manual of surgery” has contents: Trauma surgery, cardiac surgery, general thoracic surgery, pediatric surgery, neurosurgical emergencies, orthopedic injuries, urologic surgery, common surgical procedures, common postoperative surgical emergencies, and other contents. | 22. Trauma Surgery 22 Trauma Surgery Jennifer A. Leinicke Douglas . Schuerer Injury is a leading cause of death and disability around the world. This chapter outlines an overall approach to trauma care, provides a framework for therapy, and highlights critical aspects of decision making and interventions. The Eastern Association for the Surgery of Trauma (EAST) Web site () provides evidence-based clinical guidelines and can be referred to for additional detail. Trauma Care I. Prehospital Care. Field professionals are responsible for performing the three major functions of prehospital care: (1) assessment of the injury scene, (2) stabilization and monitoring of injured patients, and (3) safe and rapid transportation of critically ill patients to the appropriate trauma center. The observations and interventions performed are important in guiding the resuscitation of an injured patient. The MVIT (mechanism, v ital signs, i njury inventory, t reatment) system of reporting is one method of communicating data to the trauma team in an efficient, fast, and organized manner. A. The mechanism of a trauma partially determines the pattern and severity of injuries sustained in the event. For instance, motor vehicle collisions can cause direct contact between the driver's knees and the dashboard resulting in patellar fracture, posterior knee dislocation (with popliteal artery injury), femoral shaft fracture, and posterior rim fracture of the acetabulum. Also, feet-first falls from significant heights cause axial loading and a possible combination of calcaneal fracture, lower-extremity long-bone fracture, acetabular injury, and lumbar spine compression fracture. B. Vital signs, including level of consciousness and voluntary movement, give insight into the clinical trajectory of the patient and are a key element in leveling trauma. Emergency medical service (EMS) providers typically measure and report these values, often in less than ideal conditions. .

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