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FIRST AID AND EMERGENCY MANAGEMENT IN ORTHOPEDIC INJURIES (hb)2012
Author: M. S. DHILLON
ISBN: 9789350256459
Year: 2012
Publisher: JAYPEE BROTHERS MEDICAL PUBLISHERS PVT LTD.
Category: ORTHOPAEDICS
Edition: 1
Format: Hard Cover
Language: English
Pages: 174
 ABOUT THE TITLE
This book is essential for all levels of medical practitioners who have a role to play in the emergency management of orthopedic injuries. The book offers an unparalleled overview of emergency orthopedic practice, illustrated throughout with many highly informative line drawings, tables, radiographs and photographs that simplify diagnosis and clarify vital emergency procedures. The simply formatted book explain everything you need to know about the common orthopedic injuries the best way to diagnosis and initially stabilize them the recommended imaging studies and the evidence based treatment guidelines
Author: M S Dhillon

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 TABLE OF CONTENTS
1 Introduction to Fractures and Dislocations 1
MS Dhillon, Sarvdeep S Dhatt
• Classification Based on Etiology 2
• Classification Based on the Pattern of Fracture 2
• Classification Based on the Nature of fracture 4
• Joint Dislocations 4
2 Casualty Environment in Underdeveloped Countries 7
Sudhir S Babhulkar
• Accident and Emergency Services in Developing Countries: Problems and Solutions 7
• Ideal Accident and Casualty Services 8
• Effective Emergency Department Service 9
Location and Design 9
Personnel 9
Support Services 9
Equipment 10
• Optimal Emergency Care of a Trauma Victim 10
Survey of the Scene 11
Primary Survey 12
Secondary Survey 13
Tertiary Survey 13
• Emergency Management of Orthopedic Injuries 13
3 Prehospital Care for Orthopedic Trauma: The Developed Countries Perspective 15
K Vivek Pannikar, Srinivas Samsani
• Basic Principles of Prehospital Care 16
Providers and Type of Prehospital Care 16
• Ambulance Services in the UK and USA 17
Prehospital Medical Management 17
Management of Airway 17
Measures to Maintain Airway 17
Oxygenation 19
Management of Hemorrhage and Fluid Resuscitation 19
Management of Spinal Injuries 21
Pain Management 21
4 Prehospital Care for Orthopedic Trauma: The Asian Perspective 23
Nandkishore Shamrao Laud
• AIM 24
Contact 25
Rescue, Transportation 25
Personnel 25
• Concept of Prehospital Care 25
• Prehospital Care 28
5 Splints, Bandages, Slings and Braces in the Casualty Environment 29
SC Goel, Amit Rastogi
• Indication of Splintage in Trauma 29
Advantages of Splinting 30
Commonly Used Splints 30
Cramer Wire Splint 31
Pneumatic Splints 31
• Spine 31
Dorsolumbar Spine 32
• Upper Limb 32
Lateral Elbow Splint 33
Finger Splints 33
First Aid and Emergency Management in Orthopedic Injuries
• Lower Limbs 34
Thomas Knee Splint 35
• Bohler Braun Splint 35
Long Leg Splint 35 Posterior Leg Splint 36
Complications 37
6 How to Order Emergency X-rays? 38
Mandeep Singh Virk, Sharad Prabhakar, MS Dhillon
• Upper Extremity Trauma 39
Sternoclavicular (SC) Joint, Acromioclavicular (AC) and Clavicle 39
Glenohumeral Joint, Scapula and Proximal Humerus 39
• Humerus, Elbow and Forearm 40
Wrist 41
Hand 42
• Lower Extremity 42
Pelvis and Acetabulum 42
ip and Femur 43
Femoral Shaft Fractures 43
Knee 43 Foot and Ankle 43 Foot 44
7 Orthopedic Infections 46
Anil Arora, Anil Agarwal
• Orthopedic Infections in Children 47
Clinical Presentation 47
Examination 48
Laboratory Investigations 49
Imaging Studies 49
Differential Diagnosis 54
Management 56
• Orthopedic Infections in Adults 56
• Special Situations 58
Discitis 58
Septic Arthritis of Sacroiliac Joint 58
Chronic Recurrent Multifocal Osteomyelitis 59
Osteomyelitis in Sickle Cell Disease 59
• Tuberculosis 60
Spinal Tuberculosis (Pott’s Spine) 60
Tubercular Arthritis 61
Tubercular Osteomyelitis 62
Radiographic Picture 65
Diagnosis of Osteoarticular Tuberculosis 65
8 Dislocations in the Casualty: Understanding and Management 68
Sharad Prabhakar, Uttam Chand Saini, MS Dhillon
• Elbow Dislocation 70
Mechanism 70
Radiographic Evaluation 70
Management 70
• Hip Dislocations 71
Types 71
Closed Reduction 72
• Knee Dislocation 72
Classification 73 Mechanism of Injury 73
Radiographic Evaluation 73 Treatment 74
• Ankle Dislocation 74
9 First Aid in Open Fractures 76
Sarvdeep S Dhatt, Sameer Aggarwal
• Definition 76
• Classification 76
AO Soft Tissue Classification 76
• Acute Management 78
Emergency Room Care 78
History 78
Investigations 79
Radiographic Examination 79
• Surgical Management 79
Wound Care 79
Fracture Care Antibiotics 80
Wound Closure 80
Definitive Treatment 80
Complications 81
10 First Aid in Long Bone Fractures 82
Soumen Das De, Shamal Das De
• General Approach 82
Identify and Treat Acute Life-threatening Problems 82
Perform a Thorough Clinical Assessment 83
Formulate a Problem-list 84
Initiate Preliminary Treatment 84
Special Situations 85
Ensure Adequate Documentation 86
11 Emergency Management: Crushing Injuries of the Hand 88
Sudhir Warrier
• Extrication 88
• Primary Care 88
• Splintage 88
• Stopping Bleeding 89
• Tourniquet 89
• Care and Transportation of Severed Parts 89
12 First Aid in Foot and Ankle Injuries 90
Steven J Lawrence, MS Dhillon
• Ankle Sprains 90
• Ankle Fractures 91
• Talar Neck Fractures 92
• Peritalar Dislocations 93
Closed Reduction of a Peritalar Dislocation 94
• The Extruded Talus 94
Calcaneal Fractures 94
• Lisfranc Injuries 95
• Metatarsal Fractures 96
• Phalangeal Fractures 96
• Sesamoid Fractures 97
• Compartment Syndrome 97
• Foot Infections 97
13 Evaluation and Initial Treatment of Shoulder Injuries 100
Edward G McFarland, Harpal Singh Selhi, Juan Garzon-Muvdi, Steve A Petersen
• Shoulder Complex 100
• Basic Principles of Evaluation of the Shoulder Complex 100
• Serious Shoulder Injuries that can be Life-threatening 102
Posterior Sternoclavicular Dislocation 102
Penetrating Trauma to the Shoulder Area 102
Scapulothoracic Dissociation 102
• Common Shoulder Injuries and Treatment 103
Clavicle Fracture 103
Shoulder Dislocations (Glenohumeral Dislocations) 103
Proximal Humerus Fractures 104
Acromioclavicular Separations 104
Scapular Fractures 104
Rotator Cuff Injuries 105
14 Management of Acute Spinal Injuries 106
Rohit Rambani, Ben Okafor
• Anatomy and Pathophysiology 106
• Pathophysiology 109
Primary Injury 109
Secondary Injury 110
• Mechanism of Spinal Cord Injuries 110
Hyperflexion 110
Hyperflexion-rotation 110
Vertical Compression or Axial Loading 110
Hyperextension 110
Extension-rotation 110
Lateral Flexion 110
• Systemic Effects of Spinal Cord Injuries 110
• Management 112
• Prehospital Care of the Spinal Injury 112
• Radiological Assessment 114
Cervical Spine 114 Thoracolumbar Spine 115
• Use of Methylprednisolone 115
• Operative Management 115
• Prognosis 116
15 Primary Care in Patients with Pelvic Injury 117
Ramesh K Sen, Sameer Aggarwal
• Basic Pelvic Anatomy 117
• Mechanism of Disruptions 117
• Immediate Assessment of Patient with Pelvic Injury 118
• Emergency Care 118
• Consultation 118
• Making Approprite Diagnosis of Pelvic Injury 118
Physical Examination 118
Clinical Exclusion of Pelvic Injury 119
• Temporary Stabilization of Unstable Pelvis 119
• Planning X-rays 119
• Computerized Tomography Scans 119
• Other Investigations 119
• Subsequent Management of Pelvic Injury 120
Minor Pelvic Injuries 120
Major Pelvic Injuries 120
• Hemodynamic Resuscitation 120
• Stabilization of Pelvic Ring 120
Application of External Fixation 120
Problem Expected from Fixation 121
• Associated Injuries and Complications 121
Vascular Injury 121
Soft Tissue Injury—Open Pelvic Injury 121
• Associated Urological Injuries 122
Bladder Injury 122 Urethral Injury 122
• Associated Neurological Injuries 123
• Thromboembolic Complications 123
• Infection 123
• Pulmonary Complications 123
• Special Points in Patient Care 123
Transfer 123
• Medicolegal Implications in Pelvic Injury 123
16 First Aid in Polytrauma 125
Konkhet Riansuwan, Banchong Mahaisavariya
• Initial Assessment 125
Preparation 126
Triage 126
Primary Survey and Resuscitation 126
Adjuncts to Primary Survey 128
Secondary Survey 128
History-taking 128
Physical Examination 128
Adjuncts to Secondary Survey 129
Patient Re-evaluation 129
Definitive Treatment 130
• Immediate Life-threatening Conditions 130
Airway Obstruction 130
Tension Pneumothorax 130
Open Pneumothorax (Sucking Chest Wound) 130
Severe Flail Chest 131
Massive Hemothorax 131
Cardiac Tamponade 131
• Musculoskeletal Trauma 131
Principles of Musculoskeletal Trauma Management 131
Realignment of the Deformed Extremity 132
1
7 First Aid in Gunshot Injuries 133
Shivinder Sandhu, Harpreet Gill
• Weapons, Ammunition and Ballistics 133
• The Bullet Wound 134
Contents xxi
• Bone Involvement 135
• Joint Involvement and Metal Intoxication 135
• Contamination and Infection 135
• First Aid and Management 136
Emergency Care at Site of Injury 136
Care in the Hospital 136
18 First Aid and Casualty Management of Sports Injuries 142
Jaspal S Sandhu, Shweta Shenoy
• Sporting Emergencies 142
Collapsed Athlete 143
• Preparation 143
Equipment 143
Types of Slings 144
Transport 144
• Personnel 144
• Management 144
Cardiopulmonary Resuscitation 144
Bleeding from Scalp 147
Bleeding from Nose 147
Bleeding from Ear 147
Bleeding from Eye 148
Bleeding from Mouth 148
Bleeding from the Gums 148
Vaginal Bleeding 148
• Head Injuries 148
Concussion 149
Cervical Spine Injury 150
• Pulmonary Emergencies 150
• Gastrointestinal Emergencies 151
Splenic Contusion and Rupture 151
Liver Injuries 151
• Genitourinary Emergencies 151
Ureter, Bladder and Urethral Trauma 151
• Unconscious Emergencies 152
Epilepsy 152
Diabetes 152
Stroke 152
Heart Attack 152
Environmental Emergencies 152
19 First Aid in Disasters 154
Raj Bahadur, Sarvdeep S Dhatt
• Trauma Centers 155
Level I 155
Level II 155
Level III 156
Level IV 156
• Triage 157
Disaster Triage 157
Importance of Retriage 157
20 Minor Orthopedic Emergencies 159
MS Dhillon, Ravi Gupta
• Minor Cuts and Lacerated Wounds 159
Diagnosis 159
• Animal Bites 160
• Acute Back Pain 160
• Closed Bone Fractures and Dislocations 160
• Pulled Elbow Syndrome (Nursemaid’s Elbow) 160
Pathoanatomy 160
Clinical Features 160
Imaging 160 Management 160
• Cervical Strains and Sprains 161
Description 161
Clinical Features 161
Differential Diagnosis 161
Imaging 162
Electrodiagnostic Studies 162
Management 162
• Fight Bite and Clenched-fist Injury 162
Description 162
Clinical Features 162
Imaging 163
Management 163
• Subungual Hematoma 163
Description 163
History 163
Clinical Features 163
Differential Diagnosis 163
Imaging 163
Management 163
• Interphalangeal Collateral Ligament Sprain 164
Description 164
Clinical Features 164
Differential Diagnosis 164
Imaging 164
Management 164
21 Orthopedic Emergencies: The Nurses’ Viewpoint 166
Sukhpal Kaur, Sarvdeep S Dhatt, Sharad Prabhakar
• Historical Perspective 166
• Triage and the Trauma Nurse 167
• General Management 168
Clinical Management Considerations 168
Violence in the Casualty 168
Index 171
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