Trauma Care Pre-Hospital Manual

Introduction

Acknowledgements

Abbreviations and acronyms

Contributors

1. Trauma: A global perspective

2. Safety

3. The incident scene

4. Communication in pre-hospital care

5. Mechanism of injury

6. The primary survey

7. Catastrophic haemorrhage

8. Airway management

9. Chest injuries

10. Shock

11. Entrapment and extrication

12. Head injury

13. Spinal injuries

14. Musculoskeletal trauma

15. Analgesia, sedation and emergency anaesthesia

16. The injured child

17. Trauma in pregnancy

18. Trauma in the elderly

19. Burns

20. Firearms, ballistics and gunshot wounds

21. Blast injuries

22. Trauma management in the austere pre-hospital environment

23. Mass casualty situations

24. Retrieval and transport

25. Handover and documentation

26. Law and ethics in pre-hospital care

27. Research and audit in pre-hospital care

28. Training in pre-hospital emergency medicine (PHEM)

29. Trauma systems

Annex A Practical procedures in thoracic trauma

Annex B Traumatic cardiac arrest

Index

This new book provides evidence based guidelines for the immediate clinical management of major trauma.It has been written by clinicians with many years of trauma experience, and endorsed as authoritative by Trauma Care (UK).

The UK now has highly effective trauma systems. Clinical developments include the introduction of damage control resuscitation, tranexamic acid, blood product resuscitation, novel hybrid resuscitation and an emphasis on the control of major external haemorrhage as part of a new ABCDE approach. Consequently, more individuals with major trauma are surviving than ever before. Optimal pre-hospital care is essential for improved survival rates and reduced morbidity.

Ian Greaves FRCEM FRCP FRCSEd FIMC FASI DTM&H DMCC DipMedEd L/RAMC.Consultant in emergency medicine, James Cook University Hospital Middlesbrough and Defence Medical Services UK

Col Ian Greaves was educated at the Manchester Grammar School and graduated from the University of Birmingham Medical School in 1986, training initially in general medicine. He joined the British Army in 1999 as a consultant in Emergency Medicine. He is a fellow of the Royal Colleges of Emergency Medicine, Physicians (London) and Surgeons of Edinburgh.

Between 2008 and 2014 he was Defence Consultant Advisor in Emergency Medicine and clinical lead for Pre-hospital Care for the three Armed Services. He deployed to both Iraq and Afghanistan. Col Greaves was Honorary Surgeon to HM Queen Elizabeth II from 2011 to 2014 and was made Officer of the Order of St John in 2005. He is a fellow of the Royal Society of Arts and of the Royal Geographical Society and was made an honorary fellow of the Ambulance Services Institute in 2014 for services to pre-hospital medicine.

Col Greaves holds a personal chair at the University of Teesside. He currently serves as Chief Medical Officer of the Order of St John and of St John Ambulance and as an examiner for the fellowships in Pre-hospital Emergency Medicine and Emergency Medicine and for postgraduate degrees in trauma at Queen Mary University of London.

Col Greaves is the author or editor of textbooks on trauma, pre-hospital Care, major incident management and medical responses to terrorism and is editor of the journal Trauma. He is also a member of the Northern Region NHS Clinical Senate and has been actively involved in NHS clinical service provision reviews.

Professor Sir Keith Porter FRCS FRCSEd FRCEM FFSEM FIMC FASI. Honorary professor of clinical traumatology, University of Birmingham and consultant trauma surgeon, Queen Elizabeth Hospital Birmingham

Chris Wright DIMC FRCEM RAMC, Consultant in emergency medicine, Defence Consultant Advisor in Pre-Hospital Emergency Care. Imperial College Healthcare NHS Trust and Defence Medical Services