Managing a trauma center involves complex clinical care, long nights and days, administrative work, self-examination, critical review of patient care and significant regulatory requirements. Performance improvement is the key element of trauma center effectiveness. No trauma center provides flawless care, thus all centers have opportunities to improve. A competent performance improvement program is critical to trauma center outcomes. This book provides key information on all aspects of trauma PI and program management. In some ways, PI is an art more than a science, so the more interaction program leaders have with strong PI programs, the more they can learn about how to improve their processes. The book outlines the generally accepted processes for identification of opportunities for improvement, which are the key component of performance improvement. This includes: rounding with care teams, contemporaneous chart review, audit filters, and voluntary submissions to the trauma program for review. This book explains how to triage opportunities for improvement, analyze them, form corrective actions, and finally achieve loop closure. The book covers the roles of the personnel in the PI program, what is required to dissect the opportunity to determine action plans, how to document the entire process, and how to keep track of opportunities for improvement to ensure that your program is progressively improving care. The final sections of the book deal with specific opportunities for improvement, action plans, and loop closure through the use of case studies. The book serves as a follow-up to Dr. Jeffrey Young’s recently published book Trauma Centers, which serves as a quick guide to the key components of trauma center administration, management, and patient care.

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.

Managing a trauma center involves complex clinical care, long nights and days, administrative work, self-examination, critical review of patient care and significant regulatory requirements. Performance improvement is the key element of trauma center effectiveness. No trauma center provides flawless care, thus all centers have opportunities to improve. A competent performance improvement program is critical to trauma center outcomes. This book provides key information on all aspects of trauma PI and program management. In some ways, PI is an art more than a science, so the more interaction program leaders have with strong PI programs, the more they can learn about how to improve their processes. The book outlines the generally accepted processes for identification of opportunities for improvement, which are the key component of performance improvement. This includes: rounding with care teams, contemporaneous chart review, audit filters, and voluntary submissions to the trauma program for review. This book explains how to triage opportunities for improvement, analyze them, form corrective actions, and finally achieve loop closure. The book covers the roles of the personnel in the PI program, what is required to dissect the opportunity to determine action plans, how to document the entire process, and how to keep track of opportunities for improvement to ensure that your program is progressively improving care. The final sections of the book deal with specific opportunities for improvement, action plans, and loop closure through the use of case studies. The book serves as a follow-up to Dr. Jeffrey Young’s recently published book Trauma Centers, which serves as a quick guide to the key components of trauma center administration, management, and patient care.

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.

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.

Whether you are a physician or surgeon with only occasional trauma duties, a resident rotating in trauma, or part of a full-time trauma team, this handbook will help keep your procedures and practices in line with the latest evidence-based guidelines. Included is current information for alternative airway management, ultrasound in the trauma setting, laparoscopic surgery in trauma, terrorism preparedness, damage control, the trauma systems quality improvement process, bedside procedures in the surgical intensive care unit, massive transfusion protocol, diagnosis of blunt cervical vascular injury, and much more. Presents an evidence- and experience-based guide to the evaluation and initial management of the trauma patient. Provides a comprehensive but concise trauma reference you can carry in your pocket. Consists of information direct from the residents on the frontlines at Parkland Memorial Hospital. Provides “Fast Facts and “Pearls and Pitfalls in each chapter that emphasize key points to help you find information quickly and easily. Incorporates “Evidence boxes highlighting evidence-based guidelines, when available, to help you make more rational judgments about the issues at hand. Contains up-to-date coverage of timely issues in trauma and critical care including damage control, ultrasound, bedside procedures in the ICU, and terrorism preparedness. Reflects the numerous advances made in trauma care since the last edition.

Now thoroughly up to date with new chapters, Smith’s Anesthesia for Infants and Children, 9th Edition, by Drs. Peter Davis and Franklyn Cladis, covers the information you need to provide effective perioperative care for any type of pediatric surgery. Leading experts in pediatric anesthesia bring you up to date with every aspect of both basic science and clinical practice, helping you incorporate the latest clinical guidelines and innovations in your practice. Quick-reference appendices: drug dosages, growth curves, normal values for pulmonary function tests, and a listing of common and uncommon syndromes. Outstanding visual guidance in full color throughout the book. Consult this title on your favorite e-reader, conduct rapid searches, and adjust font sizes for optimal readability. More than 100 video demonstrations, including new regional anesthesia videos, echocardiograms of congenital heart lesions, anatomic dissections of various congenital heart specimens with audio explanations, various pediatric surgical operative procedures, airway management, and much more. Table of Contents has been reorganized and new chapters added on statistics, sedation, pediatric obesity, and cardiac critical care pediatrics. A new chapter on regional anesthesia for pediatrics, including video and ultrasound demonstrations online. A new chapter on dermatology, specifically for the anesthesiologist, with more than 100 photos. A new chapter on medical missions to third-world countries, including what you should know before you go. A new Questions chapter provides opportunities for self-assessment. New coverage includes cardiac anesthesia for congenital heart disease, anesthesia outside the operating room, and a new neonatology primer for the pediatric anesthesiologist.

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.