Trauma Rules 2: Incorporating Military Trauma Rules, 2nd Edition

by Timothy J. Hodgetts (University of Birmingham, Birmingham, UK); Lee Turner

• ISBN13: 9780470757291
• ISBN10: 0470757299
• Format: eBook
• Copyright: 2008-06-01
• Publisher: BMJ Books

Summary

Trauma Rules 2 retains its lively and fun presentation to help you remember the essential principles of trauma care and feel confident about handling and treating patients appropriately in the first hours of injury. Thoroughly expanded and updated, and now including military trauma rules, the second edition of this popular pocket book now offers: * 70 easy-to-memorize rules covering the important aspects of trauma care * clear, authoritative explanations and instructive illustrations * the three principal stages of trauma management: approach to the patient, initial assessment and resuscitation, and investigation and definitive care Trauma Rules 2 is compiled especially for those dealing with the immediate and early management of the severely injured patient.

Table of Contents

The primary directives

Anxiety provokes memory loss: so learn a system and stick to it

All 4 one and one for all

Civilian and military trauma care is different

Preparation

Any time preparing is time well spent

If in doubt, call the Trauma Team

Save yourself before the casualty

The Team Leader is always right

Approach to the patient

Assume the worst and proceed accordingly

Read the wreckage

Do a frisk or take a risk

DonÆt let the obvious distract from the occult

The Trauma Team can only look or listen, not both

Initial assessment and resuscitation

Tourniquets save lives

If the bleeding is dramatic, use a novel haemostatic

If you decide to crack the chest, survivalÆs almost nil at best

The airway is more important than the cervical spine

When NEXUS guidelines clear the spine, the spinal boardÆs a waste of time

All trauma patients are dying for oxygen

It is not lack of intubation that kills, it is lack of oxygenation

Do not delay with a burned airway

Think of cricothyrotomy when all else fails

Look at the neck TWELVE times in the primary survey

A hard collar does not protect the cervical spine

All Trauma surgeons Occasionally Miss Cervical Fractures

When patients with facial injuries look up at heaven they will soon be there

Blood on the floor is lost forever more

Short and thick does the trick

Hidden blood loss will CRAMP your resuscitation

Surgery does not follow resuscitation, it is part of resuscitation

The stabbed stay stabbed until they reach theatre

O Negative is good, but you can have too much of a good thing

An injury above and below the abdomen implies an injury in the abdomen

A penetrating wound below the nipple involves the abdomen

Examination of the abdomen is as reliable as flipping a coin

Neurogenic shock is hypovolaemic shock until proved otherwise

Think of the causes of PEA or your patient is for THE CHOP

Respiratory rate is the most sensitive indicator of deterioration, but nurses record TP not TPR

Head injury alone does not cause hypotension

Resuscitate the mother and the baby will look after itself

Children are not small adults

Everyone is equal, but some are more equal than others

Limb splintage is part of resuscitation

The Glasgow Coma Scale does not measure prognosis

A patient has a front, a back, two sides, a top and a bottom

Put a finger in before putting a tube in

The agitated patient will calm down while deteriorating

You are not dead until you are death warmed up

The golden rule is golden fluid in the golden hour

It doesnÆt hurt to give analgesia

Investigation and definitive care

The golden hour belongs to the patient

You can assess vision with the eyes closed

You may read the newspaper, but you cannot read the DPL

FAST procedure, quick decision

A tension pneumothorax cannot be diagnosed on a chest X-ray

A supine chest X-ray may be worse than no chest X-ray at all

Investigation must never impede resuscitation

Serial blood gases are the signposts on the road to resuscitation

Patients are transferred, not their injuries or investigations

Never believe a transferring hospital

Better a negative laparotomy than a positive postmortem

Go down the middle and be liberal

Fix the pelvis to fix the bleeding

Biology is the mother of all fixation

The solution to pollution is dilution

It doesnÆt pay to be complacent about an elderly fracture of the rib

A missed tertiary survey is a missed injury

With multiple casualties do the most for the most

Black is beautiful, and some things are never as black as they seem

Predicting survival is hit and miss with ISS and TRISS

Stop the clot before it stops the patient

The last rule Death is the only certainty in life

ReaderÆs rules

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