525 © Springer International Publishing AG 2017 J. Breeze Et Al
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Index A airway intervention, 126–129 Abdominal injury, operative management of codeine, 145 laparoscopy, 165 diamorphine, 144–145 laparotomy, 165 Entonox, 143–144 re-look laparotomy, 167 fentanyl, 139–142 temporary abdominal closure and definitive induction and maintenance, 129–130 repair, 167 ketamine, 142–143 Absolute emergencies (AE), 2 methoxyflurane, 144 Activated protein C (APC), 114 morphine, 139 Acute pain, 135 NSAID, 146 Acute trauma coagulopathy (ATC), 111, 113 paracetamol, 146 Addiction, 138 RA techniques, 130 Aeromedical evacuation, 458, 459 tramadol, 144 Air embolism, 385 trauma team and human factors, 126 Alert; verbal; pain; unresponsive (AVPU) unconventional analgesics, 146–147 assessment, 178 gabapentinoids, 147 Amitryptilline, 147 TCADs, 147 Ammunition, 10–13 Anaesthetist’s non-technical skills framework Amniotic fluid embolism (AFE), 385 (ANTS), 347, 348 Amputation Analgesia, 131, 133 acute trans-tibial amputation, 496 ballistic trauma, 132 free-tissue transfer, 497 pain (see Pain) healthcare system, 492 Anatomic injury patterns, 39 hip disarticulation, 498 Angioembolization, 165, 313 injury patterns, 497 Angiography, PNI, 262 level decision making, 493 Ankle: Brachial Pressure Index (ABPI), 280 marked inflammatory response, 496–497 Antepartum haemorrhage (APH), 383 neurovascular structures, 494 Anterior segment injuries residual limbs, 500 cornea, 228 revision surgery, 500 epithelial defects, 229 scoring systems, 493 foreign bodies, 228 vs. soft tissue reconstruction, 492 funus, retina and optic nerve, 230 surgical resources, 494 hyphaema, 227 tissue damage and contamination, 497 lens, 228 tissue excision, 494 ocular surface burns, 229 transected diaphysis, 495 pupils, 227 upper limbs, 497 red reflex, 227 wound sepsis, 492 Antibiotics, 185, 192, 210, 221, 228, 342, Amputee rehabilitation, 514 477, 478 Anaesthesia, 125, 147 Anticoagulants, 119 © Springer International Publishing AG 2017 525 J. Breeze et al. (eds.), Ballistic Trauma, https://doi.org/10.1007/978-3-319-61364-2 526 Index Anti-personnel mines, 23–24 ballistics-neurosurgical Archbars, 247 considerations, 178 Armed Forces, 47 prognosis, 192–194 Armed Services Trauma Rehabilitation surgical treatment, 191 Outcome (ADVANCE) postoperative care, 192 Study, 521 preoperative treatment, 188–189 Artillery, 25–26 surgical management, 190–191 Ascaris lumbricoides worm, 404 Basic Symptom Control in Paediatric Assault rifle, 10 Palliative Care, 370 ATMIST handover, 89 Battlefield Advanced Trauma Life Support Atypical gunshot entrance wounds, 423, 424 (BATLS), 177, 207 Aviation physiology, 459–461 Battlefield fragment injuries, 206 Behind armour blunt trauma (BABT), 49, 58, 59 B Birmingham eye trauma terminology system, Bacteria, 22 217, 218 Ballistic injury, 13, 75–83 Bladder organ injury scoring system, 322 developments, 84 Bladder trauma drag, 14 clinical signs and symptoms, 319 medical interventions complicated extraperitoneal, 319 ABC, 82 cystography, 320 cervical spine control, 83 diagnostic approach, 320 haemorrhage control, 82–83 gross haematuria, 319 medical management intraperitoneal, 319 buddy-buddy/self-aid, 81 lacerations, 323 CUF, 80 management, 322 permissive environment, 81 operative approach, 322–324 TFC, 81 penetrating injury, 320 preparation, 83–84 retrograde cystogram, 324 scene management uncomplicated extraperitoneal, 319 assessment, 79 Blast injuries, children vs. adults, 360 command and control, 77–78 Blood-borne viruses (BBV), 31 initial approach and communication, Blunt chest injury, 367 75–76 Blunt scrotal trauma, 324 safety, 79 Body armour, 50 triage, 80 Bone strike, 178 Ballistic maxillofacial trauma, 237 Boyle’s law, 460 DCS, 242 Bracing, 211 early management, 249–250 Brain parenchyma, 178, 192 immediate management, 241–242 Bullet flight, 14–16 longer-term rehabilitation, 250–252 Bupivacaine, 132 pathophysiology, 238–240 treatment timelines, 240–241 Ballistic trauma, 178, 180–182, 191–194 C initial resuscitation and management, Calibre, 13 183–185 Cantholyis, 245 injury classification, 178–179 Cardiac injury, 160 perforating wound, 182 Care Flight triage system, 69 tangential wounds, 180 Care under fire (CUF), 81 wound penetration, 181–182 Carotid artery injuries, 268–270 MNSU, 177 Casualty, 26 neuroimaging, 185–188 evacuation, 446 PHI, 175, 176 labeling, 70 Index 527 CELOX™, 82 multi-disciplinary assessment, 509 Central venous access, children, 364 musculo-skeletal and neurological Cepahlosporins, 189 examination, 509 Cerebral perfusion pressure (CPP), 189, 192 neuropathic pain, 508 Cervical oesophagus, injuries, 400 stages, 508 Cervical spine injuries, 364 patient pathway, 505 Charlie Hebdo attack, 1 patient tracking, 508 Chemical injury, 230 psycho-social factors, 506 Chest injury, operative management, 161 surgical and medical management, 505 Child injuries therapeutic exercise/intervention, 507 assessment, 362, 363 treatment goals, 507, 510 gastric decompression, 363 Conjuctiva, 228 hypovolaemia, 362 Conjunctival swelling, 223 intravenous analgesia, 363 Contact wounds, 416, 417, 424 peripheral venous access, 363 Contemporary mandibular fracture, 250 psychological trauma, 362 Copper poisoning, 207 Chronic pain, 135 Cornea, 228 Civilian injuries, epidemiology, 361, 362 Cricothyroidotomy, 241 Clamshell thoracotomy, 161, 162 Critical Care Air Support Teams (CCASTs), Clinical forensic medicine 447, 451 definition, 409 Critical care unit, trauma documentation and handling of evidence, 409 analgesics, 440 emergency physicians, 409 assessment, admission, 437 firearm-related injury, 410 enteral feeding, 440 gunshot-wound documentation, 411 evacuation, 441 longer-term reduction, 409 extracorporeal carbon dioxide removal wound characteristics, 410 therapy, 439 Close-range and loose-contact wounds, 418 extracorporeal membrane oxygenator Cluster munitions, 24 circuits, 439 Coagulopathy, 112 low tidal volume ventilation, 438 Codeine, 145 lung protective ventilation, 439 Collecting system injury, 312 medical and nursing care, 442 Colour doppler ultrasound, 263 microbiology, 441 Combat applicator tourniquet (CAT), 281 nasojejunal feeding, 440 Combat helmets, 54 neurotrauma, 440 Command Huddle, 157 organisational factors, 442 Component separation technique, 405 pastoral support, 442 Computerised tomographic angiography, postoperative cardiovascular PNI, 260 instability, 438 Conflict rehabilitation, 508, 509 renal replacement therapy, 440 active case management, 506 resuscitation, 438 bladder management, 512 staff training, 442 case management, 512 surgical treatment, 441 discharge planning, 513 thromboprophylaxis, 439 discharge, readmission process, 513 transfusion, 440 enhanced survivability, operations, 521 Cross-leg flap, 406 exercise programs, 507 Crystalloid fluids, 114 mild traumatic brain injury, 506 CSCATTT (Command, Safety, multi-system nature, injuries, 506 Communications, Assessment, musculo-skeletal system, 505 Triage, Treatment, Transport), 64 neurological system, 505 CT traumagram, 97 outcomes measurement, 513 Cushing’s tabulation, 179 patient assessment, 506 Custodian Helmet, 58 528 Index D Decompression, 91 Damage control resuscitation (DCR), Defence Medical Rehabilitation Programme, 111, 113–120, 125, 153, 337, 365, 507 396, 397 Definitive care, 208 components, 114 Definitive repair, 167 anticoagulants, 119 Dependence, 138 DCS, 120 Diamorphine, 144 factor concentrates and fresh whole DIC. See Disseminated intravascular blood, 119–120 coagulation (DIC) HR, 115–118 Difficult airway society (DAS), 127 hypocalcaemia and hyperkalaemia, 119 Digital radiography (DR), 101 hypothermia, 118 Disseminated intravascular coagulation (DIC), permissive hypotension, 114–115 192, 385 TXA, 118 Distant-range entrance wounds, 420–422 history, 112–113 Distraction osteogenesis, 486 multiple ballistic casualties, 120 Drag force, 14 physiology Dua classification, 230 acute trauma coagulopathy, 113–114 lethal triad, 113 Damage control surgery (DCS), 120, 125, 151, E 163–169 Elective dysvascular amputee, 514 abdominal injury, operative Emergency Department management, 87, management of 90–92 laparoscopy, 165 arrival, 89 laparotomy, 165–167 decision making, 92–93 re-look laparotomy, 167 handover, 93 temporary abdominal closure initial investigations, 92 and definitive repair, 167–169 major incident, factors, 93 assessment preparation, 87–88 stable patient, 163–164 primary survey, 90 unstable patient, 163 decompression, 91 ballistic maxillofacial trauma, 242–248 definitive airway, 90 cardiac injury, 160–161 hemorrhagic shock, 91–92 Command Huddle, 157 uncontrolled external communication, 156 hemorrhage, 90 development, 152 secondary survey, 92 haemothorax and simple pneumothorax, Endophthalmitis, 226 159–160 Enhanced combat body armour (ECBA), 51 indications, 155–156 Enophthalmos, 222 integral component, 154 Entonox, 137, 143 liver injury, 152 Epidural analgesia, 131 management, 153 Epithelial defects, 229 operative management, chest injury, Ertl procedure, 499 161–163 Escharotomy, 407 outcomes, 158 Essential coverage, 50 patient selection, factors in, 155 Evacuation PNI, 259 clinical priorities, 446 posterior mediastinum, 161 definitive care, 445 and resuscitation, 446 domestic terror incident, 447, 448 Sit Rep, 158 interventions, 445 Snap Brief, 157 medical planning, 447 stages, 153 patient transfer service, 445 techniques, 154–155 strategic, 446 tension pneumothorax, 158–159 trauma network, 446 Index 529 Evisceration, 233 management, 221 Exercise-based rehabilitation ocular trauma scoring, 217 group therapy, 510 open globe injury medical social