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INTRACRANIAL PRESSURE Intracranial pressure and cerebral blood flow The brain depends on continuou...

† INTRODUCTION Head injury accounts for 3–4% of emergency department attendances, with around 15...

Examination: primary survey ATLS guidelines address a fundamental priority: ensuring uninterrupte...

Examination: secondary survey A full secondary survey will be required. Particular attention must...

History Mechanism In moderate and severe TBI, a history must be obtained from witnesses and param...

CLASSIFICATION OF HEAD INJURY The severity of head injury is classified according to the post- re...

Concussion, second impact syndrome and postconcussive syndrome Concussion is defined as the altera...

Concussion, second impact syndrome and postconcussive syndrome Concussion is defined as the altera...

Venous lactate V enous lactate is a useful marker of resuscitation and phys - - iological state....

c: Exsanguinating external haemorrhage Experience from war zones over the past 20 years has shown...

Learning objectives How to identify and assess the severely injured patient • Early treatment goa...

ROLE OF THE TRAUMA TEAM All hospitals managing severe trauma should have a dedicated trauma team ...

SECONDARY SURVEY All severely injured patients require a detailed top-to-toe exam ination after l...

FURTHER READING Sierink HJC, Treskes K, Edwards MJR et al ., for the REACT-2 Study Group. Immedia...

IDENTIFICATION OF SEVERE TRAUMA The severely injured patient, with multiple injuries to di ff er e...

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C: Circulation and haemorrhage control All patients require adequate intravenous (IV) access with...

D: Disability and E: Exposure On admission, the GCS score should be calculated ( Table 27.1 ), th...

DAMAGE CONTROL SURGERY VERSUS EARL Y TOTAL CARE As discussed in Chapter 26 , the concept of dama...

A: Airway with cervical spine control All trauma patients should have their cervical spine immobi...