Cambridge University Press 978-1-108-48934-8 — Color Atlas of Emergency Trauma Edited by Demetrios Demetriades , Carl R

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Cambridge University Press 978-1-108-48934-8 — Color Atlas of Emergency Trauma Edited by Demetrios Demetriades , Carl R. Chudnofsky , Elizabeth R. Benjamin Index More Information

Index

anticoagulants, geriatric trauma beanbag rounds, 260–261 boom-mounted ultrasound Abbreviated Injury Score (AIS), 1 – abdominal compartment patients using, 279 bear attacks, 234, 235 machines, 359 360 antiplatelet therapy, geriatric Beck’s triad, 82 brachial-brachial index (BBI), syndrome (ACS), 219 ’ – – abdominal trauma. See also blunt trauma patients using, 279 Bennett s fracture, 151 152 50 51 aortic arch, penetrating injuries Bhopal disaster, 283 brain herniation, 18–20 abdominal trauma; – penetrating abdominal to, 93 biological disasters, 283 brain stem herniation, 1, 18 20 trauma aortic cross-clamping, 332, 333 Black Talon bullets, 248 breathing aortic occlusion. See resuscitative bladder injuries, 115–116, 117 burn injuries, 210 geriatric, 280 – pediatric, 274–275 endovascular occlusion of blast injuries, 257 258, 259, 260 geriatric patients, 277 the aorta bleeding control. See also pediatric patients, 270, 271 abuse. See nonaccidental trauma – acid burns, 222–223 aortic rupture, 90 93 resuscitative endovascular in pregnancy, 265 ACS. See abdominal compart- apixaban, 279 occlusion of the aorta; Broselow tape, 269, 270 arm, compartment pressure in, tourniquet application Brown-Séquard syndrome, 188 ment syndrome – aerodigestive trauma 242, 243, 244 neck injuries, 58 59, 60 bruise patterns, nonaccidental blunt neck injuries, 69 arm splints. See upper extremity soft tissue injuries, 228 trauma, 275, 281 penetrating neck injuries, 42, splints blood autotransfusion, after bucket handle avulsion injury, 53–56 asphyxia, traumatic, 99 hemothorax drainage, 79, 104 aspirin, 279 324, 325 bullets air embolism, 334 – airway management. See also atlantoaxial dislocation, 190 blood pressure designs, 247 248 atlanto-occipital dislocation, 189 in geriatric patients, 278 high-velocity, 123, 251–253 cricothyroidotomy – basilar skull fracture, 6, 7 atlas fractures, 193 in pediatric patients, 271 low-velocity, 123, 249 251 – atropine, for pediatric patients, in pregnancy, 265 myths and facts about, burn injuries, 210, 211 212 – complex oromaxillofacial 271 blowout fracture, 30, 31 261 262 – autotransfusion, after blunt abdominal trauma, 102 removal of, 236 trauma, 36 37 – – facial injury, 25, 35 hemothorax drainage, 79, bladder injuries, 115 116, 117 velocity of, 248 249 geriatric trauma, 277 324, 325 clinical examination, 102 burn injuries, 210 – avascular necrosis, 153, colorectal injuries, 122, ACS with, 219 neck injury, 43, 53 56, 57, 58 – – pediatric trauma, 270, 271, 312 AVPU scale, 271 duodenal injuries, 118 119 chemical, 222 223 AIS. See Abbreviated Injury Score axonotmesis, 148 general management, 103 circumferential, 219, 220, 221, alkali burns, 222 hemoperitoneum diagnosis in, 239, 246 ballistics 105 clinical examination, 210, 211 Allis closed reduction technique, – – – 169 blast injuries, 257 258, 259, investigations, 102 103 electrical, 223 225 260 liver injuries, 108–111, 112, excision and grafting, 217–218 amniotic fluid embolization, 268 – amoxicillin–clavulanic acid, definitions, 247 249 275 extent of, 212 – high-velocity projectiles, 123, mechanism of injury in, fourth-degree, 217 231 232 – – amputations 251 253 103 104, 105 full thickness (third degree), low-velocity projectiles, 123, mistakes and pitfalls, 103 215–217 extremity, 144 – – – field, 289–290, 291, 292 249 251 pancreatic injuries, 112 113 general management, 211 212 myths and facts, 261–262 renal injuries, 114–115, 275 inhalation injury, 211–212, mangled extremity, 138, 139, – – 226, 227, 228 nonlethal weapons, 260 261 small-bowel injuries, 120, 121 218 219 shotgun injuries, 253–257 splenic injuries, 105–108, 275 investigations, 211 andexanet alpha, 279 – – animal attacks, 234, 235. See also balloon occlusion, 58 59. See also urethral injuries, 117 118 mistakes and pitfalls, 212 cat bite injury; dog bite resuscitative endovascular blunt cardiac trauma, 89, 90 outcomes of, 225 occlusion of the aorta blunt diaphragmatic injuries, 95, partial thickness (second injury – – ankle dislocation, 176–177 barcode sign, 364 365 96 degree), 213 214, 215 Barton fracture, 155 blunt neck trauma, 65 scald, 221, 222 ankle fractures, 176 – ankle splints, 355–357 basilar skull fractures, 5 6, 7 laryngotracheal trauma, 69 superficial (first degree), 213 battery powered driver, IO access vascular injuries, 65–68 burst fractures anterior cord syndrome, 189 – – anterior-posterior ankle splint, using, 304, 306 308 blunt thoracic aortic injury, cervical spine, 197 198 Battle’s sign, 5 90–93 lumbar spine, 204–206 356 ’ anti D Immune globulin Baux score, 212 Bohler s angle, 180 buttock, compartment pressure G (RhoGam), 265–266 BBI. See brachial-brachial index bombings, 284, 285 in, 244 367

© in this web service Cambridge University Press www.cambridge.org Cambridge University Press 978-1-108-48934-8 — Color Atlas of Emergency Trauma Edited by Demetrios Demetriades , Carl R. Chudnofsky , Elizabeth R. Benjamin Index More Information

Index

C-1 fractures, 193 chest trauma. See thoracic injury for penetrating neck injuries, disaster resources C-2 fractures, 194, chest tube insertion. See thora- 43, 53–56, 58 international assistance, 294 C-3 to C-7 fractures, 195, costomy tube insertion percutaneous, 313, 317–319 local assistance, 293 196–199 chest wall injuries, 72 surgical instruments, 312–313 national assistance, 294 caliber, ballistics, 247 child abuse. See nonaccidental tips and pitfalls, 319 dislocation. See specific capillary leak syndrome, 210 trauma cricothyrotomy, for complex dislocations carboxyhemoglobin, 211 children. See pediatric trauma oromaxillofacial trauma, displaced fractures, skull, 3 cardiac arrest, emergency room chylothorax, 99 36–37 distal tibia IO catheterization, resuscitative thoracotomy circulation crush injuries 306–308 for, 58–59, 60, 72, 87–89, burn injuries, 210 abdominal trauma, 103–104 diuretics, in geriatric patients, 328 geriatric patients, 278 disaster medicine, 292 278 cardiac defibrillation, internal, pediatric patients, 271 DMORTs. See Disaster Mortuary 332 in pregnancy, 265 dabigatran, 279 Operational Response cardiac injury. See also penetrat- circumferential burns, 219, 220, decompressive fasciotomy, Teams ing cardiac injury 221, 239, 246 238–239, 246 dog bite injury, 229–232 blunt, 89, 90 clavicle fracture, 162–163 deep partial thickness burns, 214, double sugar-tong splint, cardiac massage, 332 clindamycin, 231–232 215 350–351 cardiac medications, in geriatric clopidogrel, 279 degloving injury, 226 doxycycline, 231–232 patients, 277, 278 closed fractures, skull, 3 dens fractures, 194, DPA. See diagnostic peritoneal cardiac rupture, 89, 90 Colles’ fracture, 154–155 dental trauma, 38–39 aspirate cardiac tamponade, 82, 83, 84, 85 colorectal injuries, 122, depressed skull fractures, 3, 4 DPL. See diagnostic peritoneal cardiac view, FAST, 363–364 comminuted fractures, skull, 3, 4 diagnostic laparoscopy lavage cardiotocography, 267 compartment pressures abdominal trauma, 122, 127 duodenal injuries, 118–119 carotid artery in buttock, 244 diaphragmatic injuries, 95 blunt trauma to, 65–68 in forearm, 243, 244 for thoracic injury, 71 ear injury, 24, 25 penetrating trauma to, 53, in lower leg, 245 diagnostic peritoneal aspirate EDH. See epidural hematoma 61–63 measurement of, 241–242 (DPA) eFAST. See extended focused cat bite injury, 232 musculoskeletal injury with, abdominal trauma, 102–103, assessment with sonography CED. See conductive energy 136, 137 105 for trauma devices normal, 238 equipment, 342, 344 EFM. See electronic fetal central cord syndrome, 188 in thigh, 244 general principles, 342 monitoring central venous access in upper arm, 242, 243 open technique, 344 elbow dislocation, 157–158 complications, 302 compartment syndrome. See also pelvic fractures, 166 elder abuse. See nonaccidental general principles, 295 extremity compartment percutaneous Seldinger trauma instruments, 295–296 syndrome technique, 342–343 elderly. See geriatric trauma patient positioning and abdominal, 219 tips and pitfalls, 344 electrical burns, 223–225 landmarks, 296–298 in burn injuries, 211, 212, 219, diagnostic peritoneal lavage electronic fetal monitoring pre procedure, 296 220, 221, 239, 246 (DPL), 102–103, 342 (EFM), 267 removal, 302 disaster medicine, 292 diaphragmatic injuries Ellis classification system, 38 technique, 299–302 soft tissue injuries with, 227, blunt, 95, 96 emergency cesarean section, 268 tips and pitfalls, 302–303 229 penetrating, 95 emergency response, 286 central venous catheter kit, complete spinal cord transection, traumatic hernia, 96, 97, 98 field safety, 286, 287 295–296 186–187 diffuse axonal injury, 22 incident command, 286 cerebral contusion, 14–15 complex oromaxillofacial diffuse cerebral edema, 20, 21 logistics, 287–288 cerebral edema, 20, 21 trauma, 36–38 disability rescue effort guidelines, 288 cerebral perfusion pressure compression fractures burn injuries, 210 subacute care, 288 (CPP), 1 cervical spine, 197–198 geriatric patients, 278 supplies, 287 cerebral resuscitation, 1–2 lumbar spine, 204–206 pediatric patients, 271 emergency room resuscitative cervical spine injuries, 181 concussion, pediatric patients, 23 disaster medicine. See also emer- thoracotomy anatomy, 181 conductive energy devices gency response general principles, 328 facet dislocation, 200, (CED), 260–261 compartment syndrome, 292 incision, 329–330 investigations, 182–183, 184 corneal abrasion, 25, 26 field amputation for indications for, 72 lower spine fractures, 195, corticosteroids, for spinal injury, entrapment, 289–290, 291, patient positioning, 329 196–199 185, 188, 208 292 for penetrating cardiac injury, mistakes and pitfalls, 185 CPP. See cerebral perfusion field triage, 285–286 87–89, 328 pediatric, 207–208, 273–274 pressure injury epidemiology, 283 for penetrating neck injuries, upper spine dislocations, cranial nerve injury injury treatment, 288–292 58–59, 60 189–191, 192 facial injury with, 25 psychological injuries, 292 procedure, 330–334 upper spine fractures, facial nerve, 39, 40, 41 tips and pitfalls, 294 surgical instruments, 328–328 192–194, 195 skull fracture with, 6 types of disasters, 282–284, tips and pitfalls, 334 cervicothoracic spinal injuries, cricothyroidotomy 285 emphysema, subcutaneous, 81 202, complications, 319 Disaster Mortuary Operational endovascular occlusion balloon. cesarean section for facial injury, 25 Response Teams See resuscitative endovascu- indications for emergency, 268 general principles, 312 (DMORTs), 288 lar occlusion of the aorta peri-mortem, 268 open, 313–317 disaster preparedness and entrapment, field amputation Chance fractures, 206 patient positioning, 313 planning, 292 for, 289–290, 291, 292 chemical burns, 222–223 in pediatric patients, hospital, 293 epicardial pacing, 333 chemical disasters, 283 270, 312 prehospital, 292–293 epidemics, 283

368

Index

epidural hematoma (EDH), 7–9 cranial nerve injury, 39, 40, 41 LUQ view, 361–362 Haiti earthquake of 2010, 282, epiphyseal injuries, 140–141 general management, 25 pelvic fractures, 166 283, 285, 288, 289, 292 escharotomy, 219, 220, 221, 239, investigations, 24 penetrating cardiac injury, 83, hand splints. See forearm and 246 mistakes and pitfalls, 25 85 hand splints esophageal trauma nasal injuries, 24, 35 RUQ view, 360–361 Hangman’s fracture, 194, 195 neck injuries, 42, 53–56 oral trauma, 38–39 suprapubic views, 362–363 Hare Traction Splint, 353, 354 thoracic injury, 98 parotid gland, 40, 41 thoracic views, 364–365 head injury, 1 transmediastinal gunshot penetrating trauma, 35, 36 tips and pitfalls, 366 brain herniation, 18–20 wounds, 93–94 facial nerve injury, 39, 40, 41 for trauma in pregnancy, 266 clinical examination, 1 excision, of burn injuries, 217–218 factor Xa inhibitors, geriatric Foley’s catheter balloon diffuse axonal injury, 22 explosion disasters, 284, 285 trauma patients using, 279 tamponade, for penetrating diffuse cerebral edema, 20, 21 explosive bullets, 248 falcine herniation, 19 neck injuries, 58–59 general management, 1–2 explosives, 257–258, 259, 260 falls, in geriatric patients, 277, 281 foramen magnum herniation, geriatric trauma, 279 exposure family, in pediatric trauma, 271 19–20 intracranial hematomas, burn injuries, 210 fasciotomy, 238–239, 246 forearm, compartment pressure 7–15 geriatric patients, 278 FAST. See focused assessment in, 243, 244 investigations, 1 pediatric patients, 271 with sonography for trauma forearm and hand splints, mistakes and pitfalls, 2 extended focused assessment Federal Emergency Management 351–353 pediatric, 22–23, 271–273 with sonography for trauma Agency (FEMA), 292–293, forearm fractures, 157, penetrating, 15–18 (eFAST), 358 294 foreign bodies scalp injuries, 2, 3 for thoracic injury, 70, 89 Federal National Incident impaled in neck, 60, 61 skull fractures, 3–6, 7 thoracic views, 364–365 Management System, 286 impaled thoracic, 100 tips and pitfalls, 23 extension teardrop fracture, 196 FEMA. See Federal Emergency ocular, 26, 27 heart. See cardiac injury extremity compartment Management Agency retained, 235–236, 237 hemopericardium, 363–364 syndrome, 238–239 femoral artery, REBOA insertion four-finger technique, 312 hemoperitoneum, 105 in buttock, 244 through, 336–338 fourth-degree burns, 217 hemothorax, 78, 79, 324, 325 clinical presentation, 239–240 femoral head and neck fractures, fractures. See also splinting; spe- eFAST detection of, 364–365 compartment pressure 171 cific fractures herniation measurement in, 241–242 femoral nerve injury, 150 classification of, 137 brain, 18–20 complications of, 245 femoral shaft fracture, 172 nonaccidental trauma traumatic diaphragmatic, 96, in forearm, 243, 244 femoral vein, central venous patterns, 275, 276 97, 98 investigations, 240–241 access via, 295, 297–298, full thickness burns, 215–217 HERT. See Hospital Emergency in lower leg, 245 300, 302–303 Response Team management, 246 Ferno-Trac Traction Splint, 353, Galeazzi fractures, 156, 157 high-pressure injection injury, mistakes and pitfalls, 246 354 gastric distention, 274–275 235 in thigh, 244 fetal heart rate (FHR), 267 GCS. See Glasgow Coma Scale high-velocity projectiles, 123, in upper arm, 242, 243 fetal resuscitation. See pregnancy geriatric trauma 251–253 extremity injuries. See also fetomaternal bleeding, 265–266, abdominal, 280 hilar occlusion, 334 splinting; tourniquet 267 airway, 277 Hill–Sachs deformity, 160 application FHR. See fetal heart rate breathing, 277 hip dislocation, 168, 169 amputations, 144 field amputation, 289–290, 291, chest, 280 hip fractures, 170–172, 280 mangled extremity, 138, 139, 292 circulation, 278 hollow-point bullets, 247 226, 227, 228 field safety, 286, 287 disability, 278 Horner’s syndrome, 47 nerve injuries associated with, field triage, 285–286 exposure, 278 Hospital Emergency Response 150, 151 fight bites, 233–234 general principles, 277 Team (HERT), 289–290, eye injuries first degree burns, 213 goals of care in, 281 291, 292 clinical examination, 24 first metacarpal fractures, head and spinal trauma, 279 human bite injury, 233–234 corneal abrasion, 25, 26 151–152 imaging studies for, 277, humeral fracture, 159 general management, 25 flail chest, 75–76 278–279 hydrofluoric acid burns, 222–223 hyphema, 27 flexion teardrop fracture, 196 nonaccidental, 281 hyphema, 27 ocular foreign bodies, fluid resuscitation oral anticoagulants and, 279 26, 27 burn injuries, 210, 211, 212 pitfalls, 281 IAH. See intra-abdominal periorbital lacerations, 29–30 compartment syndrome, 246 presentation and primary hypertension retrobulbar hematoma, 29 fluoroquinolones, for dog bites, survey, 277–278 ICP. See intracranial pressure ruptured globe, 27, 28 231–232 skeletal trauma/pelvic idarucizumab, 279 eyebrow lacerations, 30 focused assessment with fractures, 280 IEDs. See improvised explosive sonography for trauma suicide attempts, 281 devices facet dislocation, 200, (FAST), 358. See also gestational age, 266, 267 IJV. See internal jugular vein facial fractures extended focused assess- Glasgow Coma Scale (GCS), 1, impaled foreign bodies Le Fort, 33, 34 ment with sonography for 271 in neck, 60, 61 mandible, 32 trauma globe rupture, 27, 28 thoracic, 100 orbital wall, 30, 31 abdominal trauma, 102, 103, grafts, burn injuries, 217–218 improvised explosive devices zygoma, 32, 33 105, 122 greenstick fractures, 142, (IEDs), 258, 259, 260 facial injury, 24. See also eye advantages, 358 gunshot injuries. See also ballis- incident command system, 286 injuries cardiac view, 363–364 tics; specific anatomical sites infant concussion syndrome, 23 clinical examination, 24 equipment and protocol, transmediastinal, infants. See pediatric trauma complex oromaxillofacial 359–360 93–94 infection trauma, 36–38 limitations, 358–359 transpelvic, 127, 128 after cat bites, 232

369

Index

infection (cont.) penetrating neck injuries, 42, metronizadole, 231–232 natural disasters, 282–283 after dog bites, 229–232 53–56 MFH. See maternal fetal neck hematoma, 43, 53–56, 57, after human bites, 233–234 lateral canthotomy, 29 hemorrhage 58 inhalation injury, 211–212, lateral mass fractures, 199 Monteggia fractures, 156, 157 neck injury, 42. See also pene- 218–219 lateral popliteal nerve injury, 150 Morel-Lavallée lesion, 226 trating neck injuries Integrated Public Alert and Le Fort fractures, 33, 34 mouth anatomical zones and, 43, 44, Warning System (IPAWS), left upper quadrant (LUQ) view, clinical examination, 24 45 292–293 FAST, 361–362 oral trauma, 38–39 blunt trauma, 65–69 internal cardiac defibrillation, 332 leg, compartment pressure in, musculoskeletal injury, 136. See clinical examination, 42 internal jugular vein (IJV), 244, 245 also splinting general management, 43 central venous access via, leg splints. See lower extremity amputations, 144 investigations in, 42–43 295, 296, 299, 300, 302–303 splints ankle dislocation, 176–177 mistakes and pitfalls, 43 international assistance, disaster ligamentous injuries, cervical calcaneal fractures, 179–180 needle thoracostomy, 76–77 resources, 294 spine, 191, 192 classification of fractures, 137 negative pressure therapy, intra-abdominal hypertension linear fracture, skull, 3, 4 clavicle fracture, 162–163 228–229 (IAH), 219 lip lacerations, 38–39 clinical examination, 136 nerve injuries intracranial hematomas Lisfranc fracture, 178 elbow dislocation, 157–158 cranial, 6, 25, 39, 40, 41 cerebral contusion, 14–15 liver injuries epiphyseal injuries, 140–141 peripheral, 149, 150, 151 epidural hematoma, 7–9 blunt, 108–111, 112, 275 femoral shaft fracture, 172 neurogenic shock, 182, 185, 187 intraventricular hemorrhage, penetrating, 128–131 forearm fractures, 157, neuropraxia, 148 13, 14 local assistance, disaster general management, 136 neurotmesis, 148 subdural hematoma, 8, 9–12 resources, 293 geriatric trauma, 280 nightstick fractures, 156, 157 traumatic subarachnoid long arm anterior splint, hip dislocation, 168, 169 nonaccidental trauma hemorrhage, 12–13 349, 350 hip fractures, 170–172, 280 geriatric patients with, 281 intracranial pressure (ICP), 2 long arm posterior splint, humeral fracture, 159 pediatric patients with, 23, intraosseous (IO) access, 304 349–350 investigations, 136 221, 275, 276 anatomical sites, 304–306 long leg posterior splint, 355 knee dislocation, 174–176 nonlethal weapon injuries, complications, 310 lower extremity splints Lisfranc fracture, 178 260–261 contraindications, 304 ankle, 355–357 lunate and perilunate nuclear energy disasters, 284 distal tibia, 306–308 long leg posterior, 355 dislocation, 153–154 equipment, 304 traction, 353–355 Maisonneuve fracture obstetric ultrasound, for trauma indications, 304 lower leg, compartment pressure complex, 176 in pregnancy, 266, 267 patient preparation, 304–306 in, 245 mangled extremity, 138, 139, ocular exam, 24 proximal humerus, 305 low-velocity projectiles, 123, 226, 227, 228 ocular foreign bodies, 26, 27 proximal tibia, 306, 308–309 249–251 metacarpal fractures, 151–152 odontoid fractures, 194, sternal, 304, 305, 309–310 lumbar spine injuries metatarsal base fractures, 179 open chest tube, 320–322 tips and pitfalls, 311 anatomy, 181, 182 mistakes and pitfalls, 137 open cricothyroidotomy, intraparenchymal hemorrhage, Chance fractures, 206 open fractures, 138 313–317 14 compression burst fractures, open joint injury, 140 open DPA, 344 intraventricular hemorrhage, 13, 204–206 patellar fracture, 172–173 open fractures 14 fracture-dislocation, 207, pelvic fractures, 164–168, 280 musculoskeletal, 138 intubation. See airway lunate dislocation, 153–154 peripheral nerve injury, 149, skull, 3, 4, 5 management lung contusion, 79–80, 274, 280 150, 151 open joint injury, 140 IO access. See intraosseous access lung sliding, 364–365 peripheral vascular injury, oral anticoagulants, geriatric IPAWS. See Integrated Public LUQ view. See left upper quad- 145–148 trauma patients using, 279 Alert and Warning System rant view radial head fractures, 158 oral trauma, 38–39 luxatio erecta, 161–162 scaphoid fractures, 153, orbital wall fracture, 30, 31 jacketed bullets, 247 scapholunate dislocation, 153 orthopedic injuries. See muscu- joint injury, 140 Maisonneuve fracture complex, scapula fracture, 164 loskeletal injury JumpStart, 286 176 shoulder dislocation, 160–162 osteomyelitis, 138 mandible fracture, 32 sternoclavicular dislocation, Kehr’s sign, 102 mangled extremity, 138, 139, 226, 163 pancreatic injuries, 112–113, 132 Kendrick Traction Device, 353, 227, 228 subtalar dislocation, 177–178 pandemics, 283 354 mannitol, 1–2, 22, 246 supracondylar fracture, parotid gland injury, 40, 41 kidney injury. See renal injury manual bone probe device, IO 142–143 partial thickness burns, 213–214, Kleinhauer-Betke test, access using, 309–310 tendon injury, 144–145 215 265–266 manual needle, IO access using, tibial plateau fracture, 173 patellar fracture, 172–173 knee dislocation, 174–176 304, 308–309 torus and greenstick fractures, PCC. See prothrombin complex knife blade, impaled, mass disasters. See disaster 142, concentrate 60, 61, 100 medicine wrist fractures, 155 PDX 1 bullets, 248 maternal fetal hemorrhage myoglobinuria PECARN clinical prediction rule, lacrimal system lacerations to, (MFH), 265–266, 267 compartment syndrome with, 272 29–30 maternal resuscitation. See 238–239, 240, 245 pediatric trauma, 269 laminae fractures, 199 pregnancy electrical burns with, 224, 225 abdominal, 274–275 laparoscopy. See diagnostic medial popliteal nerve injury, 150 airway, 270, 271, 312 laparoscopy median nerve injury, 149, 150 nasal injuries, 24, 35 breathing, 270, 271 laryngotracheal trauma metacarpal fractures, 151–152 national assistance, disaster circulation, 271 blunt neck injuries, 69 metatarsal base fractures, 179 resources, 294 disability, 271

370

Index

epiphyseal injuries, 140–141 initial evaluation and uterine contractions with, 267 rotatory subluxation of C-1 on exposure, 271 management of, 47 uterine rupture, 267–268 C-2, 190–191 family help during, 271 physical examination of, prevention, disaster, 293 ruptured globe, 27, 28 head injury, 22–23, 271–273 45–46, 47 projectiles RUQ view. See right upper nonaccidental, 23, 221, 275, plain radiography of, 42–43, high-velocity, 123, 251–253 quadrant view 276 47, 48, 60, 61 low-velocity, 123, 249–251 primary survey, 269–271 subclavian vessel trauma in, prothrombin complex Sager Emergency Traction rapid sequence intubation in, 64, 65 concentrate (PCC), 279 Splint, 353, 354 271 vascular structure evaluation proximal humerus IO SAH. See subarachnoid secondary survey of, 271–275, in, 42, 50–51, 52, 53 catheterization, 305 hemorrhage 276 vertebral artery trauma in, 63, proximal tibia IO SALT. See Sort, Assess, special considerations, 269 64 catheterization, 306, Lifesaving interventions, spinal injury, 207–208, penetrating spinal cord injuries, 308–309 Treatment/Transport 273–274 208, 209 psychological injuries, disaster Salter–Harris classification, thoracic, 274 penetrating thoracic outlet medicine, 292 140–141 tips and pitfalls, 276 injuries, 93 pulmonary contusion, 79–80, sawn-off shotgun injuries, vital signs in children, 269 penicillin, 231–232 274, 280 256–257 pedicle fractures, 199 percutaneous chest tube, scald burns, 221, 222 pelvic fractures, 164–165 322–324 rabies prophylaxis, 232 scalp injuries, 2, 3 clinical examination, 165, 166 percutaneous raccoon eyes, 5 scaphoid fractures, 153, geriatric trauma, 280 cricothyroidotomy, 313, radial fractures, 157, scapholunate dislocation, 153 investigations, 166 317–319 radial gutter splint, 352 scapula fracture, 164 management, 166–168 percutaneous Seldinger radial head fractures, 158 sciatic nerve injury, 150 penetrating abdominal trauma, technique, 342–343 radial nerve injury, 149, 150 SCIWORA. See spinal cord 122 pericardial effusion, 83, 85 radiation disasters, 284 injury without radio- clinical examination, 122 pericardiocentesis, 70, 85 rapid sequence intubation, 271 graphic abnormality colorectal injuries, 133, 134 pericardium, opened, 330, 331 REBOA. See resuscitative endo- scored bullets, 247 general management, 122–123 perilunate dislocation, 153–154 vascular occlusion of the SCV. See subclavian vein investigations, 122, 125–127 peri-mortem cesarean section, aorta SDH. See subdural hematoma liver injuries, 128–131 268 renal injury seatbelt sign, 66, 102, 104, 105 mechanism of injury in, periorbital lacerations, 29–30 blunt, 114–115 second degree burns, 213–214, 123–124, 125 peripheral nerve injury, 149, 150, compartment syndrome with, 215 mistakes and pitfalls, 123 151 238–239, 240, 245 seizure prophylaxis, 3, 15, 18 pancreatic injuries, 132 peripheral vascular injury, in pediatric patients, 275 ShakeAlert system, 292–293 renal injuries, 132–133 145–148 penetrating, 132–133 shaken baby syndrome, 22 splenic injuries, 131 peritalar dislocation, 177–178 after soft tissue injuries, 229 Shenton’s line, 170 transpelvic gunshot injuries, placental abruption, 266, 267 rescue effort guidelines, 288 shotgun injuries, 253–257 127, 128 plaster preparation, splinting, resuscitative endovascular shoulder dislocation, 160–162 vascular injuries, 134–135 348–349 occlusion of the aorta Siedel’s test, 27 penetrating cardiac injury, 82, 83. pneumopericardium, 83, 84 (REBOA) signs, disaster, 292–293 See also emergency room pneumothorax, 76–77, 79 catheter and sheath removal, Simple Triage and Rapid resuscitative thoracotomy eFAST detection of, 364–365 340 Treatment (START), 286 diagnosis of, 83, 84, 85 popliteal artery injury, 174–176 general principles, 335–336 skeletal trauma. See musculoske- late sequelae of, 89 popliteal nerve injury, 150 partial, 341 letal injury retained cardiac missile in, 85, position of function, 352 technique, 336–339, 340 skull fractures, 3–5 86 posterior ankle splint, 355–356 tips and pitfalls, 340–341 basilar, 5–6, 7 penetrating diaphragmatic post-traumatic stress disorder, resuscitative thoracotomy. See small-bowel injuries, 120, 121 injuries, 95 292 emergency room resuscita- Smith fracture, 155 penetrating facial trauma, 35, 36 pregnancy, 263 tive thoracotomy soft tissues injuries, 226, 227 penetrating head injury, 15–18 amniotic fluid embolization, retained cardiac missile, 85, 86 cat bites, 232 penetrating neck injuries 268 retained foreign bodies, 235–236, chest, 72 aerodigestive tract evaluation anatomical changes, 264, 265 237 dog bites, 229–232 in, 42, 53–56 EFM for, 267 retrobulbar hematoma, 29 high-pressure injection injury, airway management for, epidemiology of trauma in, RhoGam. See anti D Immune 235 43, 53–56, 57, 58 263–264 globulin G investigations and monitoring, anatomical zones and, 43, 44, fetomaternal bleeding, 267 rib fractures 227 45 imaging studies for, 266 flail chest with, 75–76 local complications of, 227 angiography for, 42–43, 51, 52, indications for emergency geriatric trauma, 280 management, 228–229 53, 62, 63, 64, 65 cesarean section in, 268 lower (ninth to twelfth) ribs, mistakes and pitfalls, 236–237 bleeding control in, 58–59, 60 laboratory testing, 265–266 74 retained foreign bodies, carotid artery trauma in, 53, peri-mortem cesarean section middle (third to eighth) ribs, 235–236, 237 61–63 in, 268 73, 74 systemic complications of, 227 CFD of, 42–43, 51 physiological changes, 265 pediatric, 274 wild animal attacks, 234, 235 CT scan in, 42–43, 48–49, 50, placental abruption, 266, 267 upper (first or second) ribs, 73 Sort, Assess, Lifesaving 62, 63, 64 tips and pitfalls, 268 right upper quadrant (RUQ) interventions, Treatment/ epidemiology of, 45 trauma resuscitation in, 265 view, FAST, 360–361 Transport (SALT), 286 impaled foreign object in, 60, ultrasound examination for, rivaroxaban, 279 spinal cord injuries, 181 61 266, 267 Rolando’s fracture, 151–152 anterior cord syndrome, 189

371

Index

spinal cord injuries (cont.) subarachnoid hemorrhage penetrating cardiac injury, trimethoprim–sulfamethoxazole, Brown-Séquard syndrome, (SAH), 12–13 82–89 231–232 188 subclavian vein (SCV), central penetrating thoracic outlet tripod fracture, 32, 33 central cord syndrome, 188 venous access via, 295, 296, injuries, 93 troponin levels, 71, 89, 90 clinical examination, 182 297, 299, 302–303 pneumothorax, 76–77, 79, tube thoracostomy. See thora- complete spinal cord subclavian vessels, penetrating 364–365 costomy tube insertion transection, 186–187 trauma to, 64, 65 rib fractures, 73–74, 274, 280 general management, 185 subcutaneous emphysema, 81 subcutaneous emphysema, 81 ulnar fractures, 157, mistakes and pitfalls, 185 subdural hematoma (SDH), 8, thoracic duct injury, 99 ulnar gutter splint, 353 pediatric, 207–208 9–12 tips and pitfalls, 100–101 ulnar nerve injury, 149, 150 penetrating, 208, 209 substance abuse, 292 transmediastinal gunshot ultrasound. See also focused spinal cord injury without radio- subtalar dislocation, wounds, 93–94 assessment with sonography graphic abnormality 177–178 traumatic asphyxia, 99 for trauma (SCIWORA), 182, 208 subxiphoid pericardial window, thoracic outlet, penetrating central venous access using, spinal injuries, 181 70, 85 injuries to, 93 296, 297, 298, 300 anatomy, 181, 182 sugar-tong splint, 351–352 thoracic spine injuries, for trauma in pregnancy, 266, cervicothoracic, 202, suicide, geriatric patients, 281 202–204 267 clinical examination, 182 superficial burns, 213 thoracic views, FAST, 364–365 upper arm, compartment facet dislocation, 200, superficial partial thickness thoracostomy needle, 76–77 pressure in, 242, 243 general management, 185 burns, 213, 214 thoracostomy tube insertion upper extremity splints geriatric trauma, 279 supracondylar fracture, 142–143 autotransfusion after, 79, 324, double sugar-tong, 350–351 investigations, 182–183, 184 suprapubic views, FAST, 325 forearm and hand, 351–353 lower cervical spine fractures, 362–363 general principles, 320 long arm, 349–350 195, 196–199 surgical field amputation, for hemothorax or urethral injuries, 117–118 lumbar, 204–206, 207 289–290, 291, 292 pneumothorax, 76, 78, 79 urokinase, 78 mistakes and pitfalls, 185 open technique, 320–322 U-splint, 356–357 pediatric, 207–208, 273–274 tarsometatarsal joints. See patient positioning, 320 uterine contractions, 267 thoracic, 202–204 Lisfranc fracture percutaneous technique, uterus upper cervical spine TASER injuries, 260–261 322–324 pregnancy changes in, 264, 265 dislocations, 189–191, 192 TBSA. See total burned surface site of, 320 rupture of, 267–268 upper cervical spine fractures, area subcutaneous emphysema 192–194, 195 teardrop fractures, 196 with poor, 81 vascular trauma. See also bleed- spinal shock, 182, 187 teeth, lost, 25, 38–39 technical complications, 325, ing control spine sign, 364 Teflon-coated bullets, 248 326, 327 abdominal, 134–135 splenic injuries TEN-4 rule, 275 tips and pitfalls, 327 blunt neck injuries, 65–68 blunt, 105–108 tendon injury, 144–145 tube removal, 325 knee dislocation, 174–176 in pediatric patients, 275 tension pneumothorax, thoracotomy. See emergency penetrating neck injuries, 42, penetrating, 131 76–77 room resuscitative 50–51, 52, 53 splinting thigh, compartment pressure in, thoracotomy peripheral vascular injury, ankle, 355–357 244 thrombin inhibitors, geriatric 145–148 after care, 349 third degree burns, 215–217 trauma patients using, vasopressors, in pregnancy, double sugar-tong, 350–351 thoracic aortic injury, 90–93 279 equipment and supplies, 348 thoracic duct injury, 99 tibial plateau fracture, 173 265 forearm and hand, 351–353 thoracic injury, 70 tissue plasminogen activator vertebral artery general principles, 348 blunt cardiac trauma, 89, 90 (tPA), 78 blunt trauma to, 65–68 long arm, 349–350 blunt thoracic aortic injury, torus fractures, 142, penetrating trauma to, 63, 64 long leg posterior, 355 90–93 total burned surface area (TBSA), vertebral body fractures, padding, 348 chest wall and soft tissues, 72 210, 211, 212 195, 196 patient preparation, 348 clinical examination, 70 tourniquet application compression fractures, plaster preparation, 348–349 diaphragmatic injuries, 95–96, general principles, 345 197–198, 204–206 splint application, 349 97, 98 procedure, 345–346 flexion and extension teardrop tips and pitfalls, 357 esophageal injuries, 98 surgical instruments, 345 fractures, 196 traction, 353–355 flail chest, 75–76 tips and pitfalls, 346–347 vital signs START. See Simple Triage and general management, tPA. See tissue plasminogen geriatric, 277 Rapid Treatment 71–72 activator pediatric, 269 sternal IO catheterization, 304, geriatric trauma, 280 traction splints, 353–355 vitamin K, 279 305, 309–310 hemothorax, 78, 79, 324, 325, transmediastinal gunshot volar splint, 351 sternoclavicular dislocation, 163 364–365 wounds, 93–94 steroids, for spinal injury, 185, impaled foreign bodies, transpelvic gunshot injuries, 127, warfarin, 279 188, 208 100 128 warnings, disaster, 292–293 Stimson closed reduction indications for thoracotomy transtentorial herniation, 18, 19 weapons. See ballistics technique, 169 in, 72 traumatic asphyxia, 99 wild animal attacks, 234, 235 stirrup splint, 356–357 investigations, 70–71 traumatic diaphragmatic hernias, wounds. See ballistics; burn inju- Strategic National Stockpile, lung contusion, 79–80, 274, 96, 97, 98 ries; soft tissues injuries 287 280 traumatic subarachnoid wrist fractures, 155 Stryker device, 241–242 mistakes and pitfalls, 72 hemorrhage, 12–13 Stun Gun injuries, 260–261 pediatric, 274 triage, disaster, 285–286 zygoma fracture, 32, 33

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