Care for patients who have suffered major trauma, for example following a road accident or a fall, has not significantly improved in the last 20 years despite numerous reports identifying poor practice, and services are not being delivered efficiently or effectively. Survival rates vary significantly, with a range from five unexpected survivors to eight unexpected deaths per 100 trauma patients, reflecting the variable quality of care. 450 to 600 lives could be saved each year in England if major trauma care was managed more effectively. For best outcomes care should be led by consultants experienced in major trauma; but major trauma is most likely to occur at night and at weekends, when consultants are not normally in the emergency department. Major trauma care is not coordinated and there are no formal arrangements for taking patients directly for specialist treatment or transferring them between hospitals. A significant number of patients that need a scan CT do not receive one. Not enough patients who need a critical care bed are given one. Access to rehabilitation services varies and patients are not always receiving the care that they need. The estimated annual lost economic output from deaths and serious injuries from major trauma is between £3.3 billion and £3.7 billion. Only 60 per cent of hospitals delivering major trauma care contribute to the Trauma Audit and Research Network (TARN). The performance of the 40 per cent of hospitals that do not submit data to TARN cannot be measured.

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.

Fully revised and updated, the Oxford Handbook of Emergency Medicine is the definitive, best-selling guide for all of the common conditions that present to the emergency department. Whether you work in emergency medicine, or just want to be prepared, this book will be your essential guide. Following the latest clinical guidelines and evidence, written and reviewed by experts, this handbook will ensure you are up to date and have the confidence to deal with all emergency presentations, practices, and procedures. In line with the latest developments in the field, such as infection control, DNR orders, advanced directives and learning disability, the book also includes new sections specifically outlining patient advice and information, as well as new and revised vital information on paediatrics and psychiatry. For all junior doctors, specialist nurses, paramedics, clinical students, GPs and other allied health professionals, this rapid-reference handbook will become a vital companion for both study and practice.

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.

The Trauma Care Manual was first published in 2000, and was the first evidence-based manual of best trauma practice. Now in its second edition, it continues to offer clear and practical guidelines for the management of victims of major trauma, reflecting current practice in the United Kingdom and Europe.The second edition benefits from an increase

Injuries are the leading cause of death and disability among people under age 35 in the United States. Despite great strides in injury prevention over the decades, injuries result in 150,000 deaths, 2.6 million hospitalizations, and 36 million visits to the emergency room each year. Reducing the Burden of Injury describes the cost and magnitude of the injury problem in America and looks critically at the current response by the public and private sectors, including: Data and surveillance needs. Research priorities. Trauma care systems development. Infrastructure support, including training for injury professionals. Firearm safety. Coordination among federal agencies. The authors define the field of injury and establish boundaries for the field regarding intentional injuries. This book highlights the crosscutting nature of the injury field, identifies opportunities to leverage resources and expertise of the numerous parties involved, and discusses issues regarding leadership at the federal level.

This case-based approach to the intensive care medicine curriculum provides 48 case studies linking core knowledge to clinical context. Topics chosen have been mapped to eight key areas of study, making this ideal for both FFICM and EDIC exam candidates.

The Manchester Triage System (MTS) is the most widely used triagesystem in the UK, Europe and Australia, with tens of millions ofpatients being processed through hospital emergencydepartments. Emergency Triage is the core text for the MTS which utilises arisk averse system of prioritisation for patients in allunscheduled care settings, and as such it is an essential text forall emergency department staff using the MTS, in particular triagenurses themselves. The second edition has been revised throughout and takes in thechanges in practice introduced into MTS since the book was firstpublished. These include: Redesigned and expanded flow charts Additional charts for allergy and palpitations New practices - such as the possibility of revascularisation forpatients with stroke New discriminators, for example acute neurological deficit andsignificant respiratory history Redefinition of existing discriminators Also new to this edition is the incorporation of sections on theuse of the risk averse system in telephone triage, in settingswhere ‘streaming’ takes place and as an early warningscore for patients in all unscheduled care settings. The tone ofthis edition reflects the more up to date, modified approach totriage while retaining the principles of clinical prioritisation,which in the authors’ words “remains a central plank ofclinical risk management in emergency care”. Emergency Triage is an essential handbook for all cliniciansinvolved in unscheduled care settings such as emergency care, walkin centres, minor injury units, primary care out of hoursservices.

Child injuries are largely absent from child survival initiatives presently on the global agenda. Through this report, the World Health Organization, the United Nations Children's Fund and many partners have set out to elevate child injury to a priority for the global public health and development communities. It should be seen as a complement to the UN Secretary-General's study on violence against children released in late 2006 (that report addressed violence-related or intentional injuries). Both reports suggest that child injury and violence prevention programs need to be integrated into child survival and other broad strategies focused on improving the lives of children. Evidence demonstrates the dramatic successes in child injury prevention in countries which have made a concerted effort. These results make a case for increasing investments in human resources and institutional capacities. Implementing proven interventions could save more than a thousand children's lives a day.--p. vii.