International trauma life support for emergency care providers

Cover
Title Page
Copyright Page
Contents
About the Editor
What’s New in This Edition
Acknowledgments
Introduction to the ITLS Course
Chapter 1 Scene Size-up
	Objectives
	Chapter Overview
	Case Presentation
	Scene Size-up
		Standard Precautions
		Scene Safety
		Total Number of Patients
		Essential Equipment and Additional Resources
		Mechanism of Injury
	Motor-Vehicle Collisions
		Frontal-Impact Collision (Head-on)
		Lateral-Impact or T-Bone Collision
		Rear-Impact Collision
		Rollover Collision
		Rotational Collision
		Occupant Restraint Systems
		Tractor Accidents
		Small-Vehicle Crashes
		Pedestrian Injuries
		Falls
	Penetrating Injuries
	Wound Ballistics
	Blast Injuries
	Case Presentation (continued)
	Summary
	Bibliography
Chapter 2 Trauma Assessment and Management
	Objectives
	Chapter Overview
	Case Presentation
	ITLS Primary Survey
		Scene Size-up
		The “Fix It” Process
		Initial Assessment
	ITLS Ongoing Exam
	Procedure: Performing an Ongoing Exam
	ITLS Secondary Survey
	Procedure: Performing a Secondary Survey
	Adjuncts for Trauma Patient Assessment
	Case Presentation (continued)
	Summary
	Bibliography
Chapter 3 Assessment Skills
	Objectives
	Procedure: ITLS Primary Survey
	ITLS Primary Survey—Critical Information
		Scene Size-up
		Initial Assessment
		Rapid Trauma Survey
	Procedure: ITLS Ongoing Exam
	ITLS Ongoing Exam—Critical Information
	Procedure: ITLS Secondary Survey
	ITLS Secondary Survey—Critical Information
		Sample History
		Vital Signs and Repeat Initial Assessment
		Neurological Exam
		Detailed Exam
	Procedure: Patient Assessment and Management
	Ground Rules for Teaching and Evaluation
Chapter 4 Airway Management
	Objectives
	Chapter Overview
	Case Presentation
	Anatomy and Physiology
		Nasopharynx
		Oropharynx
		Hypopharynx
		Larynx
		Trachea and Bronchi
		The Lungs
	The Patent Airway
		Observation
		Suction
		Airway Adjuncts
	Supplemental Oxygen
	Ventilation
		Normal Ventilation
		Positive Pressure (Artificial) Ventilation
		Compliance
		Ventilation Techniques
		Airway Equipment
	Case Presentation (continued)
	Summary
	Bibliography
Chapter 5 Airway Skills
	Objectives
	Chapter Overview
	Basic Airway Management
	Procedures: Suctioning the Airway
	Procedures: Inserting the Nasopharyngeal Airway (NPA)
	Procedures: Inserting the Oropharyngeal Airway (OPA)
	Procedures: Using a Pocket Mask with Supplemental Oxygen
	Procedures: Using the Bag-Mask
		The Pulse Oximeter
		Advanced Airway Management
		Preparation for Intubation
		Laryngoscopic Orotracheal Intubation
	Procedure: Laryngoscopic Orotracheal Intubation
		Nasotracheal Intubation
	Procedures: Face-to-Face Intubation
	Procedures: Nasotracheal Intubation
		Immediate Confirmation of Tube Placement
	Procedures: Immediate Confirmation of Tube Placement
	Procedures: Reconfirming ET Tube Position
		Using Capnometry and Capnography to Confirm and Monitor ET Tube Position
	Procedures: Confirming and Monitoring ET Tube Placement with Capnography
		Anchoring the Endotracheal Tube
		Fiberoptic and Video Intubation
Chapter 6 Thoracic Trauma
	Objectives
	Chapter Overview
	Case Presentation
	Anatomy of the Thorax
		Pathophysiology
	Emergency Care of Chest Injuries
		Airway Obstruction
		Flail Chest
	Procedures: Management of Flail Chest
	Open Pneumothorax
	Procedures: Management of Open Pneumothorax
		Massive Hemothorax
	Procedures: Management of Massive Hemothorax
		Tension Pneumothorax
	Procedures: Management of Tension Pneumothorax
		Cardiac Tamponade
	Procedures: Management of Cardiac Tamponade
		Myocardial Contusion
	Procedures: Management of Cardiac Contusion
		Traumatic Aortic Rupture
	Procedures: Management of Potential Aortic Tears
		Tracheal or Bronchial Tree Injury
		Diaphragmatic Tears
	Procedures: Management of Diaphragmatic Rupture
		Pulmonary Contusion
		Blast Injuries
	Procedures: Management of the Blast Injury Patient
		Other Chest Injuries
	Case Presentation (continued)
	Summary
	Bibliography
Chapter 7 Thoracic Trauma Skills
	Objectives
	Chest Decompression
		Indications to Perform Chest Decompression
		Performing a Chest Decompression by the Lateral Approach
	Procedures: Performing a Chest Decompression by the Lateral Approach
	Performing a Chest Decompression by the Anterior Approach
		Decompression by the Anterior Approach
	Bibliography
Chapter 8 Shock
	Objectives
	Chapter Overview
	Case Presentation
	Basic Pathophysiology
	Assessment of Shock
		Compensated and Decompensated Shock
		Evaluation of Tachycardia
		Capnography
		The Shock Syndromes
	Management and Treatment
		General Management of Post-Traumatic Shock States
		Treatment of Post-Traumatic Hemorrhage
	Procedure: Managing Shock When Bleeding Has Been Controlled
	Procedure: Managing Shock Due to Exsanguinating External Hemorrhage That You Cannot Control
	Procedure: Managing Shock Due to Internal Hemorrhage
		Special Situations in Hypovolemic Shock
		Treatment of Nonhemorrhagic Shock Syndromes
		Areas of Current Study
	Case Presentation (continued)
	Summary
	Bibliography
Chapter 9 Vascular Access Skills
	Objectives
	Cannulation of the External Jugular Vein
	Procedure: Performing External Jugular Cannulation
	Intraosseous Infusion
		Indications
		Contraindications
		Recommended Sites
		Potential Complications
	Procedure: Performing IO by Use of EZ-IO Device (Adult or Child)
	Procedure: Insertion of IO Needle by Use of the EZ-IO System
	Procedure: Performing Manual IO Infusion in a Child
	Length-Based Resuscitation Tapes
	Procedure: Estimating a Child’s Weight with a Length-Based Resuscitation Tape
	Bibliography
Chapter 10 Head Trauma
	Objectives
	Chapter Overview
	Case Presentation
	Anatomy of the Head
	Pathophysiology of Head Trauma
		Primary and Secondary Brain Injuries
		Intracranial Pressure
		Cerebral Herniation Syndrome
	Head Injuries
	Facial Injuries
		Scalp Wounds
		Skull Injuries
		Brain Injuries
	Evaluation of the Head Trauma Patient
		ITLS Primary Survey
		ITLS Secondary Survey
		ITLS Ongoing Exam
	Management of the Head Trauma Patient
	Procedure: Managing the Head Trauma Patient
	Case Presentation (continued)
	Summary
	Bibliography
Chapter 11 Spinal Trauma
	Objectives
	Chapter Overview
	Case Presentation
	The Normal Spinal Column and Cord
		Spinal Column
		Spinal Cord
	Spinal Injury
		Incidence of Spinal Injury
		Mechanisms of Blunt Spinal-Column Injury
		Pathophysiology of Spinal-Cord Injury
		Neurogenic Shock
	Assessment and Management of the Trauma Patient
		Assessing for Possible Spinal Injury
		Managing the Trauma Patient
	Case Presentation (continued)
	Summary
	Bibliography
Chapter 12 Spine Management Skills
	Objectives
	Essential Components of a Spinal Motion-Restriction System
	Goals and Principles of SMR
	Applying SMR
		Patients Requiring SMR
		SMR with a Short Extrication Device
		Emergency Rescue and Rapid Extrication
		SMR with the Long Backboard
	Procedure: Log-Rolling the Prone Patient with an Adequate Airway onto a Long Backboard
	Bibliography
Chapter 13 Abdominal Trauma
	Objectives
	Chapter Overview
	Case Presentation
	Anatomy of the Abdomen
	Types of Injuries
	Assessment and Stabilization
		Scene Size-up
		Patient Assessment
		Stabilization
		Areas of Current Study
	Case Presentation (continued)
	Summary
	Bibliography
Chapter 14 Extremity Trauma
	Objectives
	Chapter Overview
	Case Presentation
	Injuries to Extremities
		Fractures
		Dislocations
		Open Wounds
		Amputations
		Neurovascular Injuries
		Sprains and Strains
		Impaled Objects
		Compartment Syndrome
		Crush Injury
	Assessment and Management
		Scene Size-up and History
		Assessment
		Management of Extremity Injuries
	Procedure: Rules of Splinting
		Management of Specific Injuries
	Case Presentation (continued)
	Summary
	Bibliography
Chapter 15 Extremity Trauma Skills
	Objectives
	Traction Splints
	Procedure: Applying a Thomas Traction Splint (Half-Ring Splint)
	Procedure: Applying a Hare Traction Splint
	Procedure: Applying a Sager Traction Splint
	Pelvic Stabilization Techniques
	Procedure: Stabilizing the Pelvis with a Sheet or Blanket
	Procedure: Stabilizing the Pelvis with a Commercial Device
	Bleeding
		Application of Tourniquets
		Use of Hemostatic Agents
	Procedure: Applying a Hemostatic Agent
	Bibliography
Chapter 16 Burns
	Objectives
	Chapter Overview
	Case Presentation
	Anatomy and Pathophysiology
		The Skin
		Classifying Burns by Depth
		Determining the Severity of Burns
	Patient Assessment and Management
		ITLS Primary Survey
		ITLS Secondary Survey
		Patient Management
		Special Problems in Burn Management
	Procedure: Removing the Source of Chemical Burns
	Case Presentation (continued)
	Summary
	Bibliography
Chapter 17 Pediatric Trauma
	Objectives
	Chapter Overview
	Case Presentation
	Communication with the Child and Family
	Parental Consent
	Assessment and Care
		Pediatric Equipment
		Common Mechanisms of Injury
		General Assessment
		Rapid Trauma Survey or Focused Exam
		Critical Trauma Situation
		ITLS Secondary Survey
	Potentially Life-Threatening Injuries
		Hemorrhagic Shock
		Fluid Resuscitation
		Head Injury
		Chest Injury
		Abdominal Injury
		Spinal Injury
	Child Restraint Seats
	Case Presentation (continued)
	Summary
	Bibliography
Chapter 18 Geriatric Trauma
	Objectives
	Chapter Overview
	Case Presentation
	Pathophysiology of Aging
		The Aging Body
		Medications
	Assessment and Management
		ITLS Primary Survey
		ITLS Secondary Survey and Ongoing Exams
	Case Presentation (continued)
	Summary
	Bibliography
Chapter 19 Trauma in Pregnancy
	Objectives
	Chapter Overview
	Case Presentation
	Pregnancy
		Fetal Development
		Physiological Changes During Pregnancy
		Responses to Hypovolemia
	Assessment and Management
		Special Considerations
		Types of Trauma
		Domestic Violence
		Falls
		Burns
	Trauma Prevention in Pregnancy
	Case Presentation (continued)
	Summary
	Bibliography
Chapter 20 The Impaired Patient
	Objectives
	Chapter Overview
	Case Presentation
	Assessment and Management
	The Uncooperative Patient
	Case Presentation (continued)
	Summary
	Bibliography
Chapter 21 Trauma Arrest
	Objectives
	Chapter Overview
	Case Presentation
	The Unsalvageable Patient
	Airway and Breathing Problems
	Circulatory Problems
	Approach to Trauma Patients in Cardiac Arrest
		General Plan of Action
	Procedure: Initial Assessment and Critical Actions
		Considerations in Traumatic Cardiac Arrest Management
	Case Presentation (continued)
	Summary
	Bibliography
Chapter 22 Standard Precautions
	Objectives
	Chapter Overview
	Case Presentation
	Diseases of Concern
		Hepatitis B
		Hepatitis C
		Human Immunodeficiency Virus Infection
		Tuberculosis
		Multidrug-Resistant Organisms
		Ensuring Protection from Other Diseases of Concern
	Precautions for Prevention of Transmission of Infectious Agents
	Procedure: General Considerations
	Procedure: Handling and Cleaning of Items Exposed to Blood or OPIM
	Procedure: Personal Protection During Patient Exposures
	Procedure: Reporting Accidental Exposure to Blood or OPIM
	Case Presentation (continued)
	Summary
	Bibliography
GLOSSARY
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INDEX
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