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Ebook Fundamentals of surgical practice (3/E): Part 2

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Nội dung chi tiết: Ebook Fundamentals of surgical practice (3/E): Part 2

Ebook Fundamentals of surgical practice (3/E): Part 2

Common Surgical ConditionsAssessment and early treatment of patients with traumaRoss Davenport and Nigel TaiIntroductionTrauma continues to be a leadi

Ebook Fundamentals of surgical practice (3/E): Part 2ing cause of death and disability worldwide, and exceeds all other cause mortality combined in persons under the age of 36 years old. Globally each da

y 300 000 people are severely injured, with 10 000 trauma deaths. In the UK over 17 000 people die each year from accident or injury, with approximate Ebook Fundamentals of surgical practice (3/E): Part 2

ly ten times as many incapacitated or permanently disabled. The socio-economic burden to the country as a whole is difficult to quantify although esti

Ebook Fundamentals of surgical practice (3/E): Part 2

mates for trauma care in the USA are in the region of $500 billion per annum. The caveat to this is the cost of quality adjusted life years (QALYs) fo

Common Surgical ConditionsAssessment and early treatment of patients with traumaRoss Davenport and Nigel TaiIntroductionTrauma continues to be a leadi

Ebook Fundamentals of surgical practice (3/E): Part 2al life providing they receive high-quality timely intervention to enable optimal outcome from injury.Severely injured patients have 20% higher in-hos

pital mortality in England and Wales (E&W) than the USA and there has been a plateau in trauma outcomes since 1994. The 2007 NCEPOD report of the mana Ebook Fundamentals of surgical practice (3/E): Part 2

gement of severely in jured patients reported that 52% of trauma patients receive substandard care and there may be upwards of 3000 preventable deaths

Ebook Fundamentals of surgical practice (3/E): Part 2

in E&w annually.One model for the organization of trauma services is to provide a regional network, with specialist major trauma centres at the hub.

Common Surgical ConditionsAssessment and early treatment of patients with traumaRoss Davenport and Nigel TaiIntroductionTrauma continues to be a leadi

Ebook Fundamentals of surgical practice (3/E): Part 2e nearest available hospital facilities and be taken to specialist centres. Organization of trauma care in this way has been shown to improve outcomes

and reduce preventable death from trauma by up to 15-25%. Regionalization of trauma care insome countries (e.g. USA) is well-established but it has n Ebook Fundamentals of surgical practice (3/E): Part 2

ot yet been instituted nationwide in the UK. Trauma care in London was regionalized in April 2010 and a UK national scheme is proposed within the next

Ebook Fundamentals of surgical practice (3/E): Part 2

few years.Trauma surgery requires rapid decision-making with good technical ability and leadership skills. Involvement of a trauma surgeon begins at

Common Surgical ConditionsAssessment and early treatment of patients with traumaRoss Davenport and Nigel TaiIntroductionTrauma continues to be a leadi

Ebook Fundamentals of surgical practice (3/E): Part 2suscitation, surgery, critical care and rehabilitation. Successful outcomes from trauma are dependent on good teamwork, rapid recognition of problems,

early intervention and constant re-evaluation.Over the past 20 years advances in trauma care such as damage control surgery’, improved resuscitation Ebook Fundamentals of surgical practice (3/E): Part 2

strategies and the use of interventional radiology have revolutionized the management of the severely injured.Clinicians providing trauma care must fu

Ebook Fundamentals of surgical practice (3/E): Part 2

lly appreciate the relationship between mechanism of trauma, injury pattern, pathophysiological response and importance of timely treatment in order t

Common Surgical ConditionsAssessment and early treatment of patients with traumaRoss Davenport and Nigel TaiIntroductionTrauma continues to be a leadi

Ebook Fundamentals of surgical practice (3/E): Part 2d therefore we will provide some general principles of management with a focus on key treatments for common injurypatterns.Injury prevention and traum

a epidemiologyup to 50% of deaths occur at the scene from non-survivable CNS or great vessel injury’. In most casesFundamentals of Surgical Practice. Ebook Fundamentals of surgical practice (3/E): Part 2

Third Edition, ed. Andrew N. Kingsnorth and Douglas M. Bowley. Published by Cambridge University Press. © Cambridge University Press 2011.253Section 5

Ebook Fundamentals of surgical practice (3/E): Part 2

: Common Surgical Conditionsinjury prevention is the only mechanism by which this percentage can be reduced. Legislation is often required to bring ab

Common Surgical ConditionsAssessment and early treatment of patients with traumaRoss Davenport and Nigel TaiIntroductionTrauma continues to be a leadi

Ebook Fundamentals of surgical practice (3/E): Part 2he workplace; e.g.•hard hats and machine safety on building sites•control of firearms•drink-driving campaigns•seat belts•airbags•cycle lanes (cycle he

lmets remain voluntary in the UK)•traffic-calming measures.Trauma is still overwhelmingly a disease of young people and, in particular, males under th Ebook Fundamentals of surgical practice (3/E): Part 2

e age of 40 years. As the population ages, the number of elderly people injured is set to rise; older patients have more comorbidity but less physiolo

Ebook Fundamentals of surgical practice (3/E): Part 2

gical reserve; therefore they often require prolonged critical care intervention.Despite improvements in management, death from major trauma still fol

Common Surgical ConditionsAssessment and early treatment of patients with traumaRoss Davenport and Nigel TaiIntroductionTrauma continues to be a leadi

Ebook Fundamentals of surgical practice (3/E): Part 2cene of the accident/ injury.•Early (hours) - death from uncontrolled haemorrhage, e.g. major pelvic fracture with rupture of pelvic vessels or hypoxi

a, e.g. tension pneumothorax.•Late (weeks) - patients who survive the initial injury insult are at risk of developing sepsis, acute lung injury, renal Ebook Fundamentals of surgical practice (3/E): Part 2

insufficiency and multi-organ failure due to the complex pathophysiological responses to trauma.Injury mechanismBlunt injury in the form of road traf

Ebook Fundamentals of surgical practice (3/E): Part 2

fic collisions (RTCs) and falls or jumps from height account for the majority of the trauma workload in the UK. Penetrating injury (gun or knife crime

Common Surgical ConditionsAssessment and early treatment of patients with traumaRoss Davenport and Nigel TaiIntroductionTrauma continues to be a leadi

Ebook Fundamentals of surgical practice (3/E): Part 2iting the history of the accident or injury from the patient or bystanders is an essential part of recognizing the possible injury pattern. The magnit

ude and direction of force sustained by the patient is a helpful guide to likely injury severity. Markers of severe trauma include:•death of other occ Ebook Fundamentals of surgical practice (3/E): Part 2

upants in same vehicle•ejection from vehicle•marked intrusion into the passenger compartment of the vehicle•tall from height (>5 metres)

Common Surgical ConditionsAssessment and early treatment of patients with traumaRoss Davenport and Nigel TaiIntroductionTrauma continues to be a leadi

Common Surgical ConditionsAssessment and early treatment of patients with traumaRoss Davenport and Nigel TaiIntroductionTrauma continues to be a leadi

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