Advances in trauma care have accelerated over the past decade, spurred by the significant burden of injury from the wars in Afghanistan and Iraq. Between 2005 and 2013, the case fatality rate for United States service members injured in Afghanistan decreased by nearly 50 percent, despite an increase in the severity of injury among U.S. troops during the same period of time. But as the war in Afghanistan ends, knowledge and advances in trauma care developed by the Department of Defense (DoD) over the past decade from experiences in Afghanistan and Iraq may be lost. This would have implications for the quality of trauma care both within the DoD and in the civilian setting, where adoption of military advances in trauma care has become increasingly common and necessary to improve the response to multiple civilian casualty events. Intentional steps to codify and harvest the lessons learned within the military's trauma system are needed to ensure a ready military medical force for future combat and to prevent death from survivable injuries in both military and civilian systems. This will require partnership across military and civilian sectors and a sustained commitment from trauma system leaders at all levels to assure that the necessary knowledge and tools are not lost. A National Trauma Care System defines the components of a learning health system necessary to enable continued improvement in trauma care in both the civilian and the military sectors. This report provides recommendations to ensure that lessons learned over the past decade from the military's experiences in Afghanistan and Iraq are sustained and built upon for future combat operations and translated into the U.S. civilian system.

Injury is an increasingly significant health problem throughout the world, accounting for 16 per cent of the global burden of disease. The public health burden of death and disability from injury is particularly notable in low and middle income countries. These guidelines seek to establish practical and affordable standards applicable to injury or trauma care worldwide, whether in rural health posts, small hospitals, hospitals staffed by specialists or tertiary care centres. It sets out a list of key trauma treatment services designed to be achievable in all settings, and defines the various human and physical resources required. It also includes a number of recommendations for methods to promote such standards including training, performance improvement, trauma team organisation and hospital inspection.

Offering expert, comprehensive guidance on the basic science, diagnosis, and treatment of acute musculoskeletal injuries and post-traumatic reconstructive problems, Skeletal Trauma, 6th Edition, brings you fully up to date with current approaches in this challenging specialty. This revised edition is designed to meet the needs of orthopaedic surgeons, residents, fellows, and traumatologists, as well as emergency physicians who treat patients with musculoskeletal trauma. International thought leaders incorporate the latest peer-reviewed literature, technological advances, and practical advice with the goal of optimizing patient outcomes for the full range of traumatic musculoskeletal injuries. - Offers complete coverage of relevant anatomy and biomechanics, mechanisms of injury, diagnostic approaches, treatment options, and associated complications. - Includes eight new chapters dedicated to advances in technology and addressing key problems and procedures, such as Initial Evaluation of the Spine in Trauma Patients, Management of Perioperative Pain Associated with Trauma and Surgery, Chronic Pain Management (fully addressing the opioid epidemic), Understanding and Treating Chronic Osteomyelitis, and more. - Features a complimentary one-year subscription to OrthoEvidence, a global online platform that provides high-quality, peer-reviewed and timely orthopaedic evidence-based summaries of the latest and most relevant literature. Contains unique, critical information on mass casualty incidents and war injuries, with contributions from active duty military surgeons and physicians in collaboration with civilian authors to address injuries caused by road traffic, armed conflict, civil wars, and insurgencies throughout the world. - Features important call out boxes summarizing key points, pearls and pitfalls, and outcomes. - Provides access to nearly 130 instructional videos that demonstrate principles of care and outline detailed surgical procedures. - Contains a wealth of high-quality illustrations, full-color photographs, and diagnostic images. - Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

Trauma surgery has increasingly become a specialized field inspired by different principles and philosophy. A good trauma surgeon is a surgeon who knows how to perform abdominal vascular, thoracic, urologic, gynecologic, and orthopaedic procedures and is able to repair multiple traumatic injuries in the best sequence possible. In this first volume, practical, up-to-date guidance is provided on the optimal critical care and ICU management of trauma patients. In addition, individual chapters focus on specific injuries in orthopaedic trauma (and especially spinal trauma) and neurotrauma, with the aim of providing a fresh view of the surgical approach and practical suggestions for improving the skills of treating surgeons. Educational issues and the organization of a trauma center are also covered. The volume will be a handy pocket guide for trainee surgeons and any surgeon, physician, or nurse who treats trauma patients. It will be particularly relevant for emergency department physicians, critical care and ICU doctors, orthopaedic surgeons, neurosurgeons, and professionals responsible for trauma care and decision making, programs of trauma education, or organization of a trauma center. Also available: Trauma Surgery Vol. 2: Thoracic and Abdominal Trauma

Published in association with the Society for Vascular Surgery (SVS), the newly updated edition of Rich’s Vascular Trauma draws on civilian and military authorities from around the world to offer comprehensive and up-to-date coverage of the management of vascular injury. Anatomic patterns of vascular trauma including extremity, torso and cervical injury are reviewed in detail, including the latest techniques to manage non-compressible torso hemorrhage. You’ll have access to all of the current innovations across the broad spectrum of vascular trauma, presented in a well-organized fashion that allows you to quickly hone-in on the most important issues in patient care and management. Emphasizes the current management of civilian vascular injuries with an historical reflection of pioneering contributions from the battlefield. Combines the largest existing database of military vascular trauma with the experience of one of the nation's premier civilian trauma centers. Examines operative techniques and "damage control" for vascular traumas. For the first time, includes a novel International Perspectives section featuring fascinating accounts of vascular trauma from nine leading surgeons from five continents. This section focuses on innovative surgical treatments tailored to locally developed pathways of care, training solutions, and regional injury patterns. End-to-end coverage of all phases of acute vascular injury care, including a new assessment of the implications of vascular trauma in the pre-hospital setting (i.e. point of injury and en-route care). Covers the emerging hot topics, including endovascular procedures to manage trauma, contemporary use of vascular shunts, and a modern reappraisal of resuscitative endovascular balloon occlusion of the aorta for shock. An innovative chapter on the systems approach and quality improvement in vascular trauma, offering information and tactics for all providers wishing to understand how clinical systems underpin patient outcome and recovery from this challenging injury pattern. A combined civilian and military authorship from internationally recognized authorities draws on the best available evidence, experience, and lessons-learned from Afghanistan, Iraq, and the "urban battlefield." Expert Consult eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, references, and videos from the book on a variety of devices.

This new book provides evidence based guidelines for the immediate clinical management of major trauma.It has been written by clinicians with many years of trauma experience, and endorsed as authoritative by Trauma Care (UK). The UK now has highly effective trauma systems. Clinical developments include the introduction of damage control resuscitation, tranexamic acid, blood product resuscitation, novel hybrid resuscitation and an emphasis on the control of major external haemorrhage as part of a new ABCDE approach. Consequently, more individuals with major trauma are surviving than ever before. Optimal pre-hospital care is essential for improved survival rates and reduced morbidity.

In order to promote greater implementation of effective, affordable and sustainable trauma systems globally, the World Health Organization and the International Association for Trauma Surgery and Intensive Care have worked collaboratively to produce these guidelines on trauma quality improvement. The response to the growing problem of injury needs to include the improvement of care of the injured. Quality improvement (QI) programs offer an affordable and sustainable means to implement such improvements. These programs enable health care institutions to better monitor trauma care services, better detect problems in care, and more effectively enact and evaluate corrective measures targeted at these problems. The goal of this publication is to give guidance on ways in which health care institutions globally can implement QI programs oriented to strengthening care of the injured. This guidance is intended to be universally applicable to all countries, no matter what their economic level. These guidelines provide basic definitions and an overview of the field of QI, so that those not familiar with this field will have a working knowledge of it. Evidence of the benefit of QI in general and trauma QI in particular is then laid out. The main part of the publication reviews the most common methods of trauma QI, written in a how-do-to fashion. This covers a wide range of techniques. The first two of these are especially emphasized as ways in which to strengthen trauma QI in the setting of low-income and middle-income countries.

This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.

This book offers an overview of acute care surgery around the world, focusing on the four main branches of this novel subdiscipline: trauma, general emergencies, critical care, and rescue surgery. The book’s primary goal is to provide a general view of acute care surgery, while addressing the most important issues in depth. The content is divided into three parts, the first of which is dedicated to the general organization of trauma centers, including the composition of modern trauma teams. Protocols of activation and action for the trauma team, as well as damage control procedures both in the emergency room and in the surgical theatre, are described. The book also addresses the development of a trauma registry, together with the quality assessment process that can be applied. In turn, the second part describes the principal protocols for making diagnoses, with special attention to circumstances such as unstable hemodynamics, neurological deterioration, normal vital signs, and penetrating injuries. The book subsequently deals with the most important aspects of trauma to the abdomen, chest, and pelvis, with notes on both surgical and intensive care issues. Practical descriptions of how to treat principal injuries to various organs are also provided. Finally, the third part of the book is dedicated to the most frequent general surgical emergencies and rescue surgical approaches, and includes information on diagnostic support with point of care ultrasound and endoscopic advanced techniques. Presenting cutting-edge strategies, this book will be of interest to professionals involved in surgical and intensive care for emergency conditions, such as colonic perforations, obstructions, acute pancreatitis, biliary tree stones, and caustic injuries.