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This latest collection reflects the full range and vitality of the current work on the Anglo-Norman period. It opens with the R. Allen Brown Memorial Lecture for 2009, a wide-ranging reflection by the distinguished French historian Dominique Barthélemy on the Peace of God and the role of bishops in the long eleventh century. Economic history is prominent in papers on the urban transformation in England between 900 and 1100, on the roots of the royal forest in England, and on trade links between England and Lower Normandy. A close study of the Surrey manor of Mortlake brings in topography, another aspect of which appears in an article on the representation of outdoor space by Norman and Anglo-Norman chroniclers. Social history is treated in papers dealing with the upbringing of the children of the Angevin counts and with the developing ideas of knighthood and chivalry in the works of Dudo of Saint-Quentin and Benoît of Sainte-Maure. Finally, political ideas are examined through careful reading of texts in papers on writing the rebellion of Earl Waltheof in the twelfth century and on the use of royal titles and prayers for the king in Anglo-Norman charters.
Contributors: Dominique Barthélemy, Kathryn Dutton, Leonie Hicks, Richard Holt, Joanna Huntington, Laurence Jean-Marie, Dolly Jorgensen, Max Lieberman, Stephen Marritt, Pamela Taylor
Discuss the diagnosis and treatment of shock in the trauma patient.
Shock is a systemic disease caused by inadequate tissue oxygen delivery. Shock consists of both primary cellular injury due to hypoperfusion and the secondary inflammatory response that follows. Shock is a complication of many traumatic conditions and is the cause of up to half of all deaths from trauma: 40 percent due to acute hemorrhage and up to 10 percent due to multiple organ system failure long after the initial cause of shock has been controlled . This chapter describes the mechanisms of injury that lead to shock, the pathophysiologic progression of shock, the way in which shock is diagnosed and monitored, and the ways in which shock is treated. The chapter concludes with specific recommendations for resuscitation today, and a brief survey of therapies that will be important in years to come.
Shock may result from any traumatic or nontraumatic process that impairs the systemic delivery of oxygen, or that prevents its normal uptake and utilization. Table 3.1 lists the causes of shock in trauma patients, and although hemorrhage is the most common of these, it is by no means the only one. It is not unusual for shock to result from the combination of multiple triggers. Hemorrhage, tension pneumothorax, and cardiac contusion can all coexist in the patient with chest trauma, for example, with each contributing to systemic hypoperfusion.
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