Education - Handbook

HANDBOOK OF TRAUMA CARE
The Liverpool Hospital Trauma Manual
6th Edition
ISBN 1 74079 027 8

PREFACE ACKNOWLEDGEMENTS AUTHORS TABLE OF CONTENTS	i ii v ix
SECTION 1 TRAUMA SERVICE OVERVIEW AND ADMINISTRATION 1. Liverpool Hospital and Southwest Sydney 2. Departments 3. Service Area	3 7 13
4. Trauma Hotline 5. Communications 6. Education 7. Trauma Registry	21 27 31 35
SECTION 2 TRAUMA TEAM 1. Members, Roles and Responsibilities 2. Pre-Arrival Preparation 3. Activation Criteria 4. Universal Precautions 5. Team and Resource Management 6. Multiple Trauma Patients / Disaster Response 7. Resuscitation Room Documentation	41 49 53 55 57 59 61
SECTION 3 CLINICAL GUIDELINES 1. Pre-Hospital Information and Hand-over 2. Primary Survey 3. Adjuncts to Primary Survey 4. Secondary Survey 5. Adjuncts to Secondary Survey	67 69 75 77 85
6. Investigations 7. Priorities and Sequencing 8. Fluids	89 95 97
SECTION 4 MANAGEMENT ALGORITHMS 1. Blunt Abdomen 2. Penetrating Abdomen 3. Widened Mediastinum 4. Penetrating Chest 5. Moribund Penetrating Chest 6. Penetrating Extremity 7. Penetrating Neck	107 108 109 110 112 113 114
8. Pelvic Fractures - Haemodynamic Instability 9. Cervical Spine Clearance 10. Suspected Spinal Cord Injury 11. Head Injury – Mild 12. Head Injury – Severe 13. Suspected Urethral Injury 14. Moribund Patient 15. MAST Suit Removal	115 116 117 118 119 120 121 122


SECTION 5 PROCEDURES 1. Extremity Immobilisation 2. Spinal Immobilisation 3. Venous Cutdown 4. Central Venous Catheters	127 129 131 135
5. Intraosseous Catheters 6. Arterial Lines 7. Chest Drains 8. Focused Abdominal Sonography in Trauma (FAST) 9. Diagnostic Peritoneal Aspiration (DPA) / Diagnostic Peritoneal Lavage (DPL)	143 147 151 155 161
10. ED Thoracotomy 11. Cricothyroidotomy 12. Pericardiocentesis 13. Medical Anti Shock Trousers (MAST) 14. Packing for Massive Nasopharyngeal Bleeding	167 171 177 179 183
SECTION 6 DEFINITIVE CARE 1. Decision Making Decisions based on limited information Goals in the second hour Critical decision nodes 2. Documentation of Definitive Care 3. Prioritisation of Procedures and Investigations 4. Consent	189 191 193 199 207 209 213
5. Admitting Doctor 6. Daily Patient Care and Follow-up 7. Tertiary Survey 8. Clinical Pathways 9. Thromboembolism and Tetanus Prophylaxis 10. Rehabilitation 11. Trauma Anaesthesia	217 219 221 223 225 229 235
SECTION 7 TRANSPORT AND DISPOSITION 1. Intra-Hospital Transfer 2. Transferring Patients out of Liverpool Hospital 3. Patient Disposition	243 247 251
SECTION 8 SPECIAL SITUATIONS 1. Paediatrics 2. Pregnancy 3. The Elderly	257 261 269
4. Hypothermia 5. Burns	273 287

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