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Trauma and Combat Critical Care in Clinical Practice

Intensive Care Medicine (or Critical Care, the terms are used interchangeably) is an evolving specialty both within the UK and worldwide. It has recently been established as a UK speciality in it's own right, and is at the centre of the modern acute hospital, responsible for managing the sickest and most complex patients. There is a growing cadre of critical care specialists in the UK, underpinned by a large number of doctors in training within the specialty. Management of patients with severe traumatic injury is provided by intensive care specialists, often in conjunction with a range of other professionals such as surgeons and interventional radiologists. The management of these patients, who have competing complex injuries can be challenging. Traumatic injury is recognised as a significant cause of preventable mortality and such patients are now clustered within Major Trauma Centres across the UK. The Defence Medical Services of the UK have spent the last 10 years managing patients with very severe traumatic injuries, first in Iraq and most recently in Afghanistan. The lessons learnt from this experience has filtered through to the NHS, resulting in many changes to established practice. Whilst several books have been published based on this experience, none have focused on the intensive care management of such patients, which represents a vital link in the chain of survival from injury to recovery.
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Table of Contents

Treating the Critically Injured Military PatientThe Evolution of Trauma Critical Care Pre Hospital treatment of the critically injured patientInitial Management of the Critically Injured PatientHaemodynamic Resuscitation Following Traumatic Haemorrhagic Shock- an Overview Haemodynamic Optimisation of the Critically Injured Patient Blood Product and Fluid Therapy in the Critically Injured Patient Management of the Patient with Trauma Induced CoagulopathyThoracic Trauma and Management of Ventilation in the Critically Injured Patient Management of Blast Related InjuriesManaging Severe Traumatic Brain Injury outside of the Neurosciences Critical Care Unit Management of the Critically Ill Patient with Burns Surgical Problems in the Critically Ill Trauma Patient Orthopaedic Issues in the Critical Injured Patient Imaging the Critically Injured Patient Management of Sedation, Analgesia and Delirium in Critically Injured Patients Nutrition in the Critically Injured Patient Venous thromboembolism in critically injured patients Aeromedical Evacuation and Transfer of the Critically Injured Patient

About the Author

Surgeon Commander Sam Hutchings is the Royal Navy's head of specialty for Intensive Care Medicine and undertakes his clinical practice at King's College Hospital, London. He is also a clinical academic with areas of research interest covering resuscitation endpoints in traumatic haemorrhage and the use of novel point of care perfusion assessment tools. He has deployed operationally to Iraq, Afghanistan and Sierra Leone.

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