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Chapter 9 - Major trauma

from Section 1 - Clinical anaesthesia

Published online by Cambridge University Press:  19 January 2017

By
Jerry Nolan
Edited by
Ted Lin ,
Tim Smith  and
Colin Pinnock
Edited in association with
Chris Mowatt
Ted Lin
Affiliation:
Glenfield Hospital, Leicester
Tim Smith
Affiliation:
Alexandra Hospital, Redditch
Colin Pinnock
Affiliation:
Alexandra Hospital, Redditch
Chris Mowatt
Affiliation:
Royal Shrewsbury Hospital
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Summary

National Audit Office data indicate that major trauma kills 5400 people in England annually, and it is the commonest cause of death in those under 40 years. The advanced trauma life support (ATLS) course (American College of Surgeons 2008) provides a basic framework onto which hospital specialists can build their individual skills. The ATLS course focuses on the initial management of patients with major injuries during the so-called ‘golden hour’. The golden hour reflects the importance of timely treatment. A severely injured patient who is hypoxic, in haemorrhagic shock, or who has an expanding intracranial haematoma, for example, will need rapid, effective resuscitation. The aim is to restore cellular oxygenation before the onset of irreversible shock.

Type
Chapter
Information
Fundamentals of Anaesthesia , pp. 195
Publisher: Cambridge University Press
Print publication year: 2016

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References

References and further reading

American College of Surgeons Committee on Trauma. Advanced Trauma Life Support for Doctors. Student Course Manual. Chicago, IL: American College of Surgeons, 2008.Google Scholar
Brain Trauma Foundation. Guidelines for the management of severe traumatic brain injury. 3rd Edition. J Neurotrauma 2007; 24: S1–106.Google Scholar
Como, JJ, Diaz, JJ, Dunham, CM, et al. Practice management guidelines for identification of cervical spine injuries following trauma: update from the Eastern Association for the Surgery of Trauma Practice Management Guidelines Committee. J Trauma 2009; 67: 651–9.Google ScholarPubMed
Cook, TM, Woodall, N, Harper, J, Benger, J; Fourth National Audit Project. Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 2: intensive care and emergency departments. Br J Anaesth 2011; 106: 632–42.Google Scholar
Crewdson, K, Nolan, JP. Management of the trauma airway. Trauma 2011; 13: 221–232.CrossRefGoogle Scholar
Crosby, ET. Airway management in adults after cervical spine trauma. Anesthesiology 2006; 104: 1293–318.CrossRefGoogle ScholarPubMed
National Institute for Health and Care Excellence. Head Injury: Assessment and Early Management. NICE Guideline CG176. London: NICE, 2014. www.nice.org.uk/guidance/cg176.Google Scholar
Rossaint, R, Bouillon, B, Cerny, V, et al. Management of bleeding following major trauma: an updated European guideline. Crit Care 2010; 14: R52.CrossRefGoogle ScholarPubMed
Timmermann, A. Supraglottic airways in difficult airway management: successes, failures, use and misuse. Anaesthesia 2011; 66 (Suppl 2): 45–56.CrossRefGoogle ScholarPubMed
Xiao, W, Mindrinos, MN, Seok, J, et al. A genomic storm in critically injured humans. J Exp Med 2011; 208: 2581–90.Google Scholar

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