Tips & Tricks in Trauma Management Sejal G Shah
INDEX
A
Abdominal
changes 159
injury 52, 105, 106, 145
Advance trauma life support 77
Aim of trauma care system 11
Airway 32, 66
and breathing 78, 133
management 34
obstruction 32, 133
Applying bandage over head 50
Artificial ventilation 37
Automatic external defibrillator 74
B
Basic trauma life support 31
Bleeding 83
Breathing 33, 67
Bronchoscopy 100
Burn
wound 168
trauma 167
C
Call ambulance 60
Cardiac massage 41
Check breathing adequacy 33
Chemical burns 174
Chest
compression 42
injury 50, 97, 144, 145, 154
Color Doppler 109
CPR in children or infant 44
Criteria
for prehospital and hospital trauma care system 14
to face emergencies 9
Critical role in prehospital and hospital trauma care management 15
Crush injury 58
CT scan 108
D
Determine severity of head injury 92
Diagnostic peritoneal lavage 108
Disaster management 17
Dr Sejal’s
classification of trauma management 6
principle of
prolong life support 81
trauma management 6
trauma care system 11
E
Electrical burns 173
Environment 140
Equipments and monitoring 65
Exposure 50, 81, 140
F
Fetal
evaluation 164
physiology 160
First aid 29, 51
Focussed assessment of ultrasonography for trauma 109
Fracture 54, 124, 127
Fractures in elderly and children 128
Function of trauma care system 11
Future of rehabilitation 181
G
Geriatric
age group 149
trauma 148, 155
Glasgow coma scale 92
Goals of
CPR 41
prehospital and hospital trauma care system 13
trauma management in geriatrics 150
H
Head injury 90, 93, 94, 97, 141, 153
I
Immune system 155
Infants CPR 44
Inhalation burns 173
Intracranial pressure 94
Intubation 67
L
Laparotomy 110
M
Management of
airway obstruction 133
circulation 137
head injury 75
shock and bleeding 83
Mechanism of injury and triage 150
Model of trauma care system 11
Musculoskeletal
changes 155
injury 147
N
Neurologic changes 159
Neurological evaluation 49, 79
P
Parameters in triage 21
Partial obstruction in children 44
Pediatric trauma 130
Pelvic injury 53, 11
Pitfalls in
transportation 75
trauma management 9
Pregnancy
and burns injury 165
trauma 157
Prehospital and hospital trauma care system 12
R
Recent advances in
CPR 45
trauma management 9
Rehabilitation in trauma? 177
Rescue breaths 37, 40
S
Severity of injury 7
Shock 81, 82
Specific
burns 173
injury 153
Spinal
cord injury 121
injury 118, 146
Story of princess of Wales “ Diana” 25
Team of prehospital and hospital trauma care system 12
Tertiary survey 148
T
Tips and tricks in difficult intubation 73
Tips in
abdominal injury 180
chest injury 180
fracture 181
head injury 179
neurological condition 179
pelvic injury 180
prevention of head injury 94
spinal injury 180
tourniquet 84
Transport of trauma patient 62
Trauma
care system 11
team 16
Traumatic pregnant patient 161
Tricks of intubation 69
Tube thoracostomy 103
U
Ultrasonography or 3D Doppler study 161
W
Wound care 75
X
X-ray chest 99
×
Chapter Notes

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1TIPS AND TRICKS IN TRAUMA MANAGEMENT2
3TIPS AND TRICKS IN TRAUMA MANAGEMENT
Sejal G Shah MBBS MS (Orthopedic) Senior Consulting Trauma and Joint Replacement Surgeon NISARG Orthopedic and Maternity Hospital Vadodara, Gujarat, India Formerly Ex Assistant Professor Department of Orthopedics SBKS Medical College Pipariya, Vadodara, Gujarat, India
4
Published by
Jaypee Brothers Medical Publishers (P) Ltd
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4838/24 Ansari Road, Daryaganj, New Delhi - 110002, India,
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Tips and Tricks in Trauma Management
© 2011, Jaypee Brothers Medical Publishers
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photo copying, recording, or otherwise, without the prior written permission of the author and the publisher.
This book has been published in good faith that the material provided by author is original. Every effort is made to ensure accuracy of material, but the publisher, printer and author will not be held responsible for any inadvertent error(s). In case of any dispute, all legal matters are to be settled under Delhi jurisdiction only.
First Edition: 2011
9789350250327
Typeset at JPBMP typesetting unit
Printed at5
To
My beloved grandfather (late) Dr Somalal K Shah
who taught me that
if we pursue what we want, we will get that one day.
My parents, my wife and my darling children
Who are my efficiency to bring proficiency into action.6
7Foreword
This treatise will provide valuable supplementation in the management of orthopedic trauma, which is contained in major fracture texts. There is growing need for this type of detailed “how to do it” guidance.
Successive global burden of disease and injury analysis documents the growing prevalence of road traffic injuries. Systems are evolving to the level where surgeons will be able to employ modern methods of management to avoid disabilities.
Trauma cuts short many productive lives. According to the American data, injury kills one person every six minutes and disabling injury occurs every two seconds. This is accentuated in rural setting where mortalities are 50% higher. The economic impact of trauma is significant and involves both direct costs of care and lost productivity.
More number of casualties are saved because of improvement in the understanding and management of a critically injured patient. Thus more number of orthopedic traumas has to be managed than before. It should be managed right from the site of injury to returning to his original workplace with little or no disability. The integrated trauma service concept enhances education and research as well as patient care.
Separating orthopedic trauma care from general or elective orthopedic practice has advantages for both. There are strong reasons and sound case to project orthopedic trauma management as a distinct specialty because specialization means a higher level of care. It is so much easier to teach and learn good habits early in surgical career than trying to unlearn bad habits later. This is precisely what author of this treatise must be having in mind.
VM Shah MS (Orthopedic)
VM Shah Hospital
Jamnagar, Gujarat, India8
9Preface
This is a small gesture and workmanship to craft a management of trauma in this jet life.
As it was difficult to understand, how, when and what to write, because this was first time in my life that I was handling a job of writing a book. Actually, idea of writing this book came through series of events which occurred in my life in the last 15 years, from my college days to flourishing practice that compelled meto write.
This book has unique feature as Basics of Trauma Narrated in Stages of Trauma, so that students to specialized doctors can understand, remember and apply it easily and appropriately in their practical traumatic life.
It is an immense pleasure to introduce my personal views and my practical experience what my eyes and brain learnt from my teachers, colleagues and others to share with you in form of a small handbook.
It has got beautiful live photographs, diagrammatic pictures, to the point ‘steps to tips’, and ‘tracks to tricks’ to offer each one of you for your own and better world today and tomorrow. Unnecessary theory material is excluded to make it more precise and ready for practical use.
Specialized section of specific trauma is designed to deal with particular person.
Rehabilitation, least attended part in our practice, is given utmost importance to get better functional outcome.
In fact, the word Doctor is derived from the Latin word ‘Docere’ means ‘to teach’. It is very important that every doctor must be expert, trained, vigilant and accurate enough to be prepared in this unknown, undiagnosed, unwanted trauma to deal with.
I hope you would like this humble endeavor.
I wish you all a hassle free, successful and atraumatic life in this puzzling world.
Sejal G Shah10
11Acknowledgments
I have taken great efforts to write this book. However, it would not have been possible without kind support of many great people who have helped and supported me during writing and publishing of this book.
On this memorable moment of writing this book, I also would like to thank all who directly or indirectly involved with this book.
My deepest thanks to my wife Dr Shweta Shah, my sons Yug and Arnav, who helped me emotionally and morally encouraged me to pen my thoughts and experiences. She has taken pain to go through the book and make necessary corrections as and when needed.
I express my thanks to my doctors, teachers, colleagues, students, plastic surgeons, physiotherapists, my hospital staff who helped me to make a complete handbook.
I would like to express my deep sense of gratitude to Mr Tarun Duneja (Director-Publishing), Mr KK Raman (Production Manager), Mr Ashutosh Srivastava (Asstt. Editor) and the entire team of M/s Jaypee Brothers Medical Publishers (P) Ltd., New Delhi.
My special thanks to Dr VM Shah, renowned trauma surgeon for writing Foreword for this book.
And at last, I would like to thank almighty, God, and my patients for their kindness and their grace has made me what I am today.