Main description:

Both editors are active duty officers and surgeons in the U.S. Army. Dr. Martin is a fellowship trained trauma surgeon who is currently the Trauma Medical Director at Madigan Army Medical Center. He has served as the Chief of Surgery with the 47th Combat Support Hospital (CSH) in Tikrit, Iraq in 2005 to 2006, and most recently as the Chief of Trauma and General Surgery with the 28th CSH in Baghdad, Iraq in 2007 to 2008. He has published multiple peer-reviewed journal articles and surgical chapters. He presented his latest work analyzing trauma-related deaths in the current war and strategies to reduce them at the 2008 annual meeting of the American College of Surgeons. Dr. Beekley is the former Trauma Medical Director at Madigan Army Medical Center. He has multiple combat deployments to both Iraq and Afghanistan, and has served in a variety of leadership roles with both Forward Surgical Teams (FST) and Combat Support Hospitals (CSH).

Feature:

Concisely written, practical knowledge written by veterans of combat surgery

A large number of full color images illustrate difficult techniques and situations

This handbook is designed to provide the most necessary and practical knowledge needed by Surgeons working on the front lines

Back cover:

Front Line Surgery is designed to provide practical insights for surgeons whose areas of practice demand quick best-outcome based solutions to complex and urgent clinical problems.

Both editors are active duty officers and surgeons with multiple tours in Iraq. Each chapter provides detailed instructions and combat/emergency surgical principles with multiple detailed illustrations. While the focus is clearly clinical, the authors also provide clinical pearls in both traditional and non-traditional narrative.

Top Ten Combat Trauma Lessons

1. Patients die in the ER, and

2. Patients die in the CT scanner;

3. Therefore, a hypotensive trauma patient belongs in the operating room ASAP.

4. Most blown up or shot patients need blood products, not crystalloid. Avoid trying “hypotensive resuscitation” – it’s for civilian trauma.

5. For mangled extremities and amputations, one code red (4 PRBC + 2 FFP) per extremity, started as soon as they arrive.

6. Patients in extremis will code during rapid sequence intubation, be prepared, and intubate these patients in the OR (not in the ER) whenever possible.

7. This hospital can go from empty to full in a matter of hours; don’t be lulled by the slow periods.

8. The name of the game here is not continuity of care, it is throughput. If the ICU or wards are full, you are mission incapable.

9. MASCALs live or die by proper triage and prioritization – starting at the door and including which x-rays to get, labs, and disposition.

10. No Personal Projects!!! They clog the system, waste resources, and anger others. See #8 above.

Reprinted from "The Volume of Experience (January 2008 edition)", a document written and continuously updated by U.S. Army trauma surgeons working at the Ibn Sina Hospital, Baghdad, Iraq.

Contents:

Foreword.
Lorne H. Blackbourne, M.D., F.A.C.S.

Preface.
Matthew J. Martin, M.D., F.A.C.S.
Alec C. Beekley, M.D., F.A.C.S.

Top Ten Combat Trauma Lessons

Chapter 1. Prehospital and Enroute Care
Ian Wedmore, M.D.

Chapter 2. Combat Triage and Mass Casualty Management
John J. Lammie, M.D.
Joseph G. Kotora, Jr., D.O.
Jamie C. Riesberg, M.D.

Chapter 3. Initial Management Priorities: Beyond ABCDE
Alec C. Beekley, M.D., F.A.C.S.

Chapter 4. Damage Control Resuscitation
John B. Holcomb, M.D., F.A.C.S.
Timothy C. Nunez, M.D., F.A.C.S.

Chapter 5. To Operate or Image? (Pulling the Trigger)
Matthew J. Martin, M.D., F.A.C.S.

Chapter 6. Ultrasound in Combat Trauma
Benjamin Harrison, M.D., F.A.A.E.M., F.A.C.E.P.

Chapter 7. Contamination, Colostomies, and Combat Surgery
Eric K. Johnson, M.D., F.A.C.S., F.A.S.C.R.S.
Scott R. Steele, M.D., F.A.C.S., F.A.S.C.R.S.

Chapter 8. Liver and Spleen Injury Management in Combat (Old School)
Brian Eastridge, M.D., F.A.C.S.
Lorne H. Blackbourne, M.D., F.A.C.S.

Chapter 9. Pancreatic and Duodenal Injuries (Sleep when you can…)
Tommy A. Brown, M.D., F.A.C.S.

Chapter 10. Operative Management of Renal Injuries
Carlos V.R. Brown, M.D., F.A.C.S.

Chapter 11. Major Abdominal Trauma
Niten Singh, M.D.

Chapter 12. To Close or Not to Close: Managing the Open Abdomen
Craig D. Shriver, M.D., F.A.C.S.
Amy Vertrees, M.D.

Chapter 13. Choice of Thoracic Incision
Jeffrey A. Bailey, M.D., F.A.C.S.

Chapter 14. Lung Injuries
Michael S. Meyer, M.D., F.A.C.S.
Matthew J. Martin, M.D., F.A.C.S.

Chapter 15. Diagnosis and Management of Penetrating Cardiac Injury
Keith A. Havenstrite, M.D.

Chapter 16. Thoracic Vascular Injuries—Operative Management in “Enemy”
Territory
Benjamin W. Starnes, M.D., F.A.C.S.

Chapter 17. Chest Wall and Diaphragm Injury
Alec C. Beekley, M.D., F.A.C.S.

Chapter 18. Soft Tissue Wounds and Fasciotomies
Peter Rhee, M.D., F.A.C.S.
Joe DuBose, M.D.

Chapter 19. Open Fractures
Richard C. Rooney, M.D., F.A.C.S.

Chapter 20. Mangled Extremities and Amputations
Eric G. Puttler, M.D.
Stephen A. Parada, M.D.

Chapter 21. Peripheral Vascular Injuries
Charles J. Fox, M.D., F.A.C.S.

Chapter 22. The Neck
John Oh, M.D.

Chapter 23. Genitourinary Injuries (excluding kidney)
Andrew C. Peterson, M.D., F.A.C.S.

Chapter 24. Neurosurgery for Dummies
Hans Bakken, M.D.

Chapter 25. Spine Injuries
Richard C. Rooney, M.D., F.A.C.S.

Chapter 26. Face, Eye, and Ear Injuries
Tate L. Viehweg, D.M.D.

Chapter 27. Burn Care in the Field Hospital
Evan M. Renz, M.D., F.A.C.S.

Chapter 28. The Pediatric Patient in Wartime
Kenneth S. Azarow, M.D., F.A.C.S.
Philip C. Spinella, M.D., F.C.C.P.

Chapter 29. The Combat ICU Team
Kurt W. Grathwohl, M.D., F.S., F.C.C.P.

Chapter 30. Postoperative Resuscitation
Martin A. Schreiber, M.D., F.A.C.S.
Richard A. Nahouraii, M.D., F.A.C.S.

Chapter 31. Monitoring
Alec C. Beekley, M.D., F.A.C.S.
Jay Johannigman, M.D., F.A.C.S.

Chapter 32. Ventilator Management
Alexander S. Niven, M.D., F.A.C.P., F.C.C.P.
Paul B. Kettle, R.R.T.

Chapter 33. Practical Approach to Combat-related Infections and Antibiotics
Clinton K. Murray, M.D., F.A.C.P., F.I.D.S.A.

Chapter 34. Stabilization and Transfer from the Far Forward Environment
Shawn C. Nessen, D.O., F.A.C.S.

Chapter 35. Humanitarian and Local National Care
James A. Sebesta, M.D., F.A.C.S.

Chapter 36. Expectant and End of Life Care in a Combat Zone
Robert M. Rush, Jr., M.D., F.A.C.S.
Matthew J. Martin, M.D., F.A.C.S.

Appendix A. Improvise, Adapt, and Overcome: Field Expedient Methods in a Forward Environment

Appendix B. Burn Diagrams and Sample Burn Orders

Appendix C. Resources, References, and Readiness