Table Of ContentTRAUMA: CODE RED
COMPANION TO THE RCSEng DEFINITIVE
SURGICAL TRAUMA SKILLS COURSE
TRAUMA: CODE RED
COMPANION TO THE RCSEng DEFINITIVE
SURGICAL TRAUMA SKILLS COURSE
Edited by
Mansoor Khan, MBBS PhD FRCS FEBS FACS AKC
Surgeon Commander Royal Navy
Consultant Trauma and Military Surgeon
St Mary’s Hospital Major Trauma Centre
London, United Kingdom
Morgan McMonagle, MB BCh BAO MD FRCSI FACS
Consultant General
and
Trauma and Vascular Surgeon
St Mary’s Hospital Major Trauma Centre
London, United Kingdom
and The South/South West Hospital Group, Ireland
with
David M. Nott, OBE DSc MD FRCS DMCC
Professor of Conflict Surgery, Imperial College London
and
Consultant Vascular and Trauma Surgeon
St Mary’s Hospital Major Trauma Centre
London, United Kingdom
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Mansoor Khan
Morgan McMonagle
David M. Nott
Contents
Foreword by David Feliciano, MD .............ix 7 Damage Control for Severe Pelvic
Foreword by Bryan Cotton, MD, MPH .....xi Haemorrhage in Trauma ........................153
Preface ..............................................................xiii John H. Armstrong
Editors ................................................................xv
Contributors .................................................xvii 8 Trauma Laparotomy and Damage
Control Laparotomy .................................161
1 The Philosophy of Damage Control .......1
David M. Nott
Daniel Grabo, Patrick Reilly and
C. William Schwab 9 Abdominal Trauma ...................................171
Mansoor Khan
2 Ballistics and Blast Injury ..........................19
David M. Nott, Mansoor Khan and 10 Future of Trauma Surgery:
Morgan McMonagle Resuscitative Endovascular Balloon
Occlusion of the Aorta (REBOA) ..........215
3 Emergency Surgical Airway .....................45
Philip J. Wasicek, Thomas M. Scalea and
Morgan McMonagle
Jonathan J. Morrison
4 Thoracic Surgery ..........................................55
Index ...............................................................229
James V. O’Connor
5 Vascular Trauma ...........................................81
Morgan McMonagle
6 Fasciotomy of the Extremities .............139
Mark W. Bowyer
vii
Foreword
by David Feliciano, MD
While general surgery has become increasingly fragmented into subspecialties, trauma
remains the one area in which a broad-based knowledge of anatomy, evaluation, principles
of non-operative management and operative skills is mandatory. Working in such a surgical
field poses a unique problem for practising surgeons, fellows, residents and medical
students – i.e. how best to learn and then maintain the knowledge and skills necessary to
care appropriately for every injured patient arriving in the trauma room.
The Definitive Surgical Trauma Care (DSTC) course evolved from the ‘Guidelines for
Essential Trauma Care’ first developed by the International Association for the Surgery
of Trauma and Surgical Intensive Care/International Society of Surgery and published
by the World Health Organization in 2004. The goal of this document was to promote
‘inexpensive improvements in facility-based trauma care’, recognising the significant
disparities in trauma care between ‘high-income countries’ versus ‘middle- and low-
income countries’. The Definitive Surgical Trauma Skills course was subsequently
developed by the Royal College of Surgeons of England with the Royal Defence Medical
College and the Uniformed University of the Health Sciences in Bethesda, Maryland, USA.
The Definitive Surgical Trauma Skills Course is of great value as a one-stop source
for learning how to perform procedures and operations in all systems of the body.
Trauma: Code Red, this new text by Mansoor Khan and Morgan McMonagle from
St Mary’s Hospital Major Trauma Center in London, United Kingdom, can stand alone as
a consolidated textbook of trauma or be used as a companion to the RCSEng Definitive
Surgical Trauma Skills Course. The content is unique in that, following the introductory
chapters on damage control and ballistics, every other chapter is directed at definitive
and damage control approaches to clinical management. These include management of
the airway, injuries to the chest, abdomen, and pelvis, vascular injuries and fasciotomy of
the extremities, and, finally, a comprehensive review of the emerging role of resuscitative
endovascular balloon occlusion of the aorta (REBOA) in truncal trauma.
Each chapter, written by recognised authorities in the field of trauma, contains an
introductory outline, operative photographs complemented by instructional line
drawings, comprehensive line drawings describing techniques of exposure, pertinent
tables and a reading list. The reader will be rewarded with a highly practical textbook/atlas
of management that can be referred to in the trauma room or even in the operating room.
As trauma systems continue to improve around the world, there are more patients than
ever with life- and/or limb-threatening injuries arriving at trauma centres. Many of these
patients died in the field or during transit in the past. The practical skills highlighted in this
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