Severe & Multiple Trauma

Severe & Multiple Trauma


This new work from Martin Duenser, Jacques Duranteau and Thomas Geeraerts is the product of a collaboration with the ESICM section of Trauma and Emergency Medicine and is a very welcome, complete revision of this PACT module. It is up to date and well referenced module and encompasses the full (pre-hospital to rehabilitation care) approach to severe and multiple trauma and it is Advanced Trauma Life Support (ATLS) compatible.

The topic is introduced by outlining the mechanisms of Blunt, Penetrating, Blast and Thermal trauma and the corresponding severity scoring.  The clinical sequence starts with Pre-Hospital and Emergency Department care and goes straight to the ABCD of primary assessment and primary intervention for Airway / breathing,  Shock (haemorrhagic / obstructive) and Brain (herniation) emergencies.  Secondary assessment (including imaging) and secondary intervention maintains the  immediacy of this practical approach while incorporating damage control resuscitation and surgery, interventive radiology, transfusion (incl massive transfusion protocols), coagulopathy management (incl thromboelastography and tranexamic acid) and pain relief.  

The Patient Challenge (PATCH) section details the team management of a young, multi-traumatised female road traffic accident victim. The practical approach to her complex injuries is very realistic and the learning issues associated with the required sequence of multifaceted care are clearly identified.

The post-trauma care in ICU addresses (tertiary) head to toe assessment,  taking each organ system in turn e.g. thoracic, aortic, abdominal (incuding pancreatic), pelvic and long bone injury and their related complications such as rhabdomyolysis and the fat embolism syndrome. The traumatised pregnant patient is included and the overall general ICU care of the stabilised trauma patient e.g. thromboembolism and antibiotic prophylaxis,  nutrition,  sedation / management of delirium and the optimum timing of further surgery is included.  Lastly there is useful emphasis on minimising complications and promoting physical and psychological rehabilitation.

All readers, both those in training and those using PACT for Continuing Professional Development (CPD), will get immense value from this newly updated, very comprehensive module dealing with the global clinical management of this important aspect of Intensive Care Medicine practice.  

Click the link for immediate access… Severe and Multiple Trauma

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