Once again a team of volunteers representing the Military Health System and numerous clinical specialties has committed itself to delimiting state-of-the-art principles and practices of forward trauma surgery. War surgery and treatment of combat casualties at far forward locations and frequently under austere conditions continue to save lives. Military medical personnel provide outstanding health support to those serving in harm’s way. As the face of war continues to evolve so must the practice of medicine to support those who so selflessly fight the global war on terrorism. Today American military men and women face a new terrain of mobile urban terrorism and conflict. Despite advances in personal and force protection provided to our forces they remain vulnerable to blast wounds burns and multiple penetrating injuries not usually encountered in the traditional civilian setting. This publication expertly addresses the appropriate medical management of these and other battle and non battle injuries.
This edition contains new material that updates the management of war wounds and is filled with over 150 specially drawn illustrations. Equally important is the use of an outline bulleted format that is so much more concise than the verbosity of the previous editions. Additionally emphasis in this edition is on the all-important “Emergency” in Emergency War Surgery—surgery performed at levels II and III—that constitutes the raison d’ętre for military surgery.
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EDITORIAL & PRODUCTION
Chapter 1: Weapons Effects and Parachute Injuries
Mechanism of Injury
Armored Vehicle Crew Casualties
Chapter 2: Levels of Medical Care
Forward Surgical Team (FST)
Chapter 3: Triage
Triage Decision Making
Setup Staffing and Operation of Triage System
Chapter 4: Aeromedical Evacuation
Medical Evacuation Precedences
Critical Care Air Transport Teams (CCATT)
Chapter 5: Airway/Breathing
Rapid Sequence Intubation (RSI)
Chapter 6: Hemorrhage Control
Stop the Bleeding
Chapter 7: Shock and Resuscitation
Recognition and Classification
Walking Blood Bank
Chapter 8: Vascular Access
Subclavian Vein or Internal Jugular Vein
Greater Saphenous Vein
Chapter 9: Anesthesia
Induction of General Anesthesia
Rapid Sequence Intubation
Chapter 10: Infections
Soft Tissue Infections
Chapter 11: Critical Care
Resuscitation From Shock
Traumatic Brain Injury
Pulmonary System and Ventilators
Renal System and Electrolytes
Gastrointestinal System and Nutrition
Immune System and Infections
Preparation for Evacuation
Chapter 12: Damage Control Surgery
Chapter 13: Face and Neck Injuries
Soft Tissue Injuries
Penetrating Neck Trauma
Specific Face and Neck Injuries
Internal Carotid Artery
Internal Jugular Vein
Chapter 14: Ocular Injuries
Anterior Segment Injuries
Cornea Chemical Injuries
Corneal Ulcer and Keratitis
Orbital Floor (Blowout) Fractures
Laser Eye Injuries
Chapter 15: Head Injuries
Glasgow Coma Scale
Chapter 16: Thoracic Injuries
Chapter 17: Abdominal Injuries
Indication for Laparotomy
Diagnostic Peritoneal Lavage
Chapter 18: Genitourinary Tract Injuries
Chapter 19: Gynecologic Trauma and Emergencies
Emergent Total Abdominal Hysterectomy
Vaginal Hemorrhage: Not Pregnant
Vaginal Hemorrhage: Pregnancy
Precipitous Vaginal Delivery
Emergency Cesarean Section
Chapter 20: Wounds and Injuries of the Spinal Column and Cord
Thoracic and Lumbar Spine
Chapter 21: Pelvic Injuries
Chapter 22: Soft-Tissue Injuries
Chapter 23: Extremity Fractures
Chapter 24: Open Joint Injuries
Chapter 25: Amputations
Chapter 26: Injuries to the Hands and Feet
Types of Injuries
Chapter 27: Vascular Injuries
Evaluation and Diagnosis
Chapter 28: Burns
Point of Injury Care
Estimation of Fluid Resuscitation
Rule of Nines
Extremity Care Escharotomy
Grafting: "How I Do It"
Chapter 29: Environmental Injuries
Chapter 30: Radiological Injuries
Chapter 31: Biological Warfare
Chapter 32: Chemical Injuries
Chapter 33: Pediatric care Anatomic and Physiologic
Modified Glasgow Coma Scale
Rapid Sequence Intubation
Equipment Age and Weight
Commonly Used Drugs
Chapter 34: Care of Enemy Prisoners of War/Internees
UN and Geneva Convention
What Healthcare Providers Should Do
What Healthcare Providers Should Not Do
Appendix 1: Principles of Medical Ethics
Appendix 2: Glasgow Coma Scale
Appendix 3: Theater Joint Trauma Record
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