With detailed contributions and research from experts, this reference supplies an abundance of information on acid-base physiology, disorders of acid-base equilibrium, and the management and treatment of these disorders in clinical practice. A unique and timely resource, this guide provides a large number of tables, references, and figures to illustrate the relationship between the underlying physiology and diagnosis of acid-base disorders. Reviewing current information on the pathophysiology of acid-base disorders from both a molecular and integrative perspective, the book provides straightforward guidelines for the diagnosis and management of disturbances of acid-base homeostasis.

Heralding critical developments in the rapidly expanding field of therapeutic hypothermia, this reference serves as the first authoritative source on thermoregulation, body temperature manipulation, and the consequences of hypothermia. Contributors include recognized leaders and pioneers who have done much of the critical research in the field.

This state-of-the-art reference provides current and effective disease-specific strategies for the management of patients receiving mechanical ventilation-emphasizing weaning processes, monitored sedation, minimization of complications and infection, and new modes of treatment for patients in critical care. Exploring ancillary approaches, noninvasive positive pressure ventilation, oxygenation, and bronchodilator therapy as options to optimize cost and reduce injury, Ventilator Management Strategies for Critical Care discusses -methods to diagnose, manage, and avoid ventilator-associated pneumonia -consequences of extubation failure -mechanics of true closed-loop ventilation -neuromuscular blocking agents and physiological disturbances -therapy for chronic obstructive pulmonary disease (COPD) -and more! With contributions by over 40 seasoned experts in the field, Ventilator Management Strategies for Critical Care is a valuable resource for intensive or critical care and pulmonary or critical care specialists, surgical critical care specialists, anesthesiologists, physiologists, physiatrists and rehabilitation physicians, respiratory therapists, and medical school and graduate students in these disciplines.

A collection of 25 thought provoking Essays which create a bridge between the Classical personification of values and link them to current training and education in Western Medicine. This readable and erudite text provides a framework for modern clinical values - with a particular emphasis on anesthesiology - set in the context of ageless dilemmas facing each generation of physicians. Medicine as a profession carries some specific obligations.The qualities of empathy, knowledge, generosity, respect, and scholarship provide a "family" of values that was personified by the Ancients in the family of Asklepios, and which form the basis of professional values today. Moreover, a substantial amount of professional growth should come from reflection based on the experience of caring for real patients - an appreciation of the human condition. Each essay within this beautifully crafted book illustrates the importance of expertise, skill, focus, mindfulness, and collaboration, all of which are integral to professionalism in medicine, and in particular to those working in the field of anesthesiology. Anesthesiologists, Certified Registered Nurse Anesthetists and Anesthesia Assistants will find much to enhance their professional understanding within this text. The principles, values and traits of professionalism are relevant to all medical specialties and these essays provide a lyrical understanding of the traits required for professional development.

This incisive reference systematically reviews the diagnosis and treatment of common surgical and medical emergencies in elderly patients-thoroughly examining surgical interventions, drug therapies and drug prescribing protocols, life-threatening drug reactions, ethical issues, and methods of profiling patients for nursing care. Evaluates disease states and gauges optimal responses to each, supporting recommendations with valuable case studies. Written by over 40 distinguished medical experts, Acute Emergencies and Critical Care of the Geriatric Patient -describes ideal patient-physician relationships in critical care settings -highlights emergency management of myocardial infarction and cardiogenic pulmonary edema -illuminates ethical questions surrounding confidentiality, informed consent, surrogate decision making, and patient comfort -assesses special pharmacokinetic and pharmacodynamic conditions in geriatric patients -provides vital information on stroke, seizures, and spinal cord compression -investigates critical complications caused by pneumonia, meningitis, and endocarditis -explores acute lung disorders such as emphysema, chronic bronchitis, pneumonia, central nervous system dysfunction, and abnormal control of ventilation -clarifies preoperative procedures for emergency surgery -reviews anesthesia strategies for pulmonary, cardiovascular, renal, hepatic, and neurological conditions in the elderly -and more! Including over 1000 references, tables, and illustrations, Acute Emergencies and Critical Care of the Geriatric Patient is an indispensable resource for geriatricians, primary care physicians, internists, emergency medicine physicians, intensivists, hosptialists, surgeons, anesthesiologists, orthopedists, cardiologists, psychiatrists, neurologists, and internists/residents in these disciplines, as well as nurses, pharmacists, and medical students.

Critically ill paediatric transfers have expanded rapidly over the past ten years and, as such, the need for transfer teams to recognise, understand and treat the various illnesses that they encounter is greater than ever. This highly illustrated book covers a multitude of clinical presentations in a case-based format to allow an authentic feel to the transfer process. Written by clinicians with experience in thousands of transfers, it brings together many years of experience from a world-renowned hospital. Following the case from initial presentation, to resuscitation and referral and finally with the transfer itself; the book explores the clinical stabilisation, human factors decisions and logistical challenges that are encountered every day by these teams. Following the entire journey, this is an ideal resource for all professionals who may be involved in critical care transfer and retrieval medicine, particularly those working in paediatrics, emergency medicine, anaesthesiology, intensive care, or pre-hospital settings.

This updated book continues the ABCDE chapter format from the second edition, incorporating an escalating level of diagnostic and management complexity and a concise bibliography in each chapter. It remains demarcated into two sections: the first (e.g. ABCDE chapters) equips surgical trainees in managing non-ICU-based patients, whilst the second provides a basic introduction to ICU care. The chapters introduce standard definitions, pathological processes, diagnostic features and common management plans. These are based on a range of updated recommended guidelines from NICE and SIGN and common ALS principles in critical care patients, as well as current ATLS (R) and CCrISP (R) standards. The most common causes of systemic complications in surgical patients are explained, e.g. updated sections on sepsis and major haemorrhage protocols, to name but a few. A must-have revision guide for all surgical trainees, from final-year medical students through to junior surgical registrars.

This core textbook defines the pathophysiologic mechanisms underlying the disease states commonly encountered by pre-hospital care providers. The chapters are short, clinically focused and specific to the diseases, disorders, and traumatic conditions of critical interest to the EMT and pre-hospital environment. Each chapter identifies the appropriate drugs and management guidelines to be used. Designed to bridge the gap between EMT and the Physician in all emergent or acute conditions, the book includes management cautions and tips are highlighted throughout the presentation. The book is tailored specifically to the curriculum for EMT training.

The care that a patient receives in the first hours after surgery is crucial to minimizing the risk of complications. The recovery room staff must manage both comatose and physiologically unstable patients, and deal with the immediate post-operative care of surgical patients. The Complete Recovery Room Book, Sixth edition, provides nurses, surgeons, and anaesthetists with up-to-date guidance and practical tips on the post-operative management of patients. Over 30 chapters, this resource covers key aspects of recovery room management from setting-up, monitoring and equipment, and managing symptoms as well as clear and concise explanations of physiology and pharmacology. Specific chapters address the unique post-operative needs of individual types of surgery and patient groups. Practical tips and short aphorisms are offered throughout the text to help retain practical information.

This book covers the history of plastic surgery from the remarkable achievements of such ancient civilizations as India and Egypt up to the revolutionary techniques developed at the end of the Middle Age, the Renaissance and beyond. Coverage details how the knowledge of wound healing has changed and influenced plastic surgery, describes the development of various surgical reconstructive procedures and details the birth of Cosmetic Surgery.

Geriatric Trauma and Critical Care provides a multidisciplinary overview of the assessment and management of the elderly patient presenting with surgical pathology. By utilizing current literature and evidence-based resources, the textbook elucidates the unique nature of caring for the elderly population. The structure of the volume provides the reader with an overview of the physiologic and psychological changes, as well as the impact on the healthcare system, associated with the aging process. Emphasis is placed on the impact of aging, pre-existing medical problems, effects of polypharmacy, advanced directives and end-of-life wishes on acute surgical problems, including trauma and surgical critical care. Special attention is given to the ethical implications of management of the aged. The multidisciplinary contributors provide a unique point of view not common to surgical texts. The textbook is the definitive resource for practicing surgeons, emergency medicine physicians, intensivists, anesthesiologists, hospitalists, geriatricians, as well as surgical residents, nurses and therapists, all who care for elderly patients with surgical emergencies.

This book by Madbak and Dangleben has collated lot of information that has been presented and published in many disparate arenas into a single easy to read source. In an area where there is more experience and "favorite techniques" than true evidence based answers, they provide a wealth of information along with outstanding photographic support that makes this an excellent resource for all surgeons caring for this population. Similar to many things in life, when treating patients with the open abdomen one size or methodology does not fit all and this book will assuredly contain at least one possible answer to your patient's problem. Although the numbers of "open abdomens" are decreasing due to changes in resuscitation and transfusion practices, it still represents a complex complication that can be challenging to deal with. This ambitious textbook on the management of the open abdomen provides a practical approach for addressing this complex problem. One of the more unique aspects of this textbook is its detailed "How to" approach for the wide variety of techniques utilized in the management of the open abdomen. While there may be no consensus as to what constitutes the optimal management of the open abdomen, this book articulates a number of options and their advantages. Most importantly, it provides high quality photographs that enhance the step by step "How to" approach of the text. More recent developments including using biologic mesh, implementing complex abdominal wall reconstruction and utilizing minimally invasive endoscopic techniques are described. This book is not only appropriate for all practicing surgeons that deal with this complex issue, but is also relevant for residents and fellows who are just getting their first exposure to open abdomens.

In this era of evidence-based medicine, one of the biggest challenges confronting acute medicine clinicians is keeping abreast with the rapidly changing recommendations that guide clinical practice. Oxford Desk Reference: Acute Medicine allows easy access to evidence-based materials on commonly encountered acute medical problems to ensure the optimum management of the acutely unwell patient. Collating all the research-based guidelines and protocols in one easily accessible place and presenting it in a uniform style, this practical book is hugely advantageous for a busy clinician as it is not always easy to access research-based guidelines and protocols when needed in the clinic. The book is designed so that each subject forms a self-contained topic in its own right. This makes the information simple to find, read, and absorb, so that the book can be consulted in the clinic or ward setting for information on the optimum management of a particular condition. Edited by three experts in acute medicine, this book should never be far from the acute medicine clinician's side.

Owing to their frequency and possible consequences and considering the fact they frequently affect young people, trauma tic lesions of the thoraco lumbar spine represent a special point of interest within the field of Neurotraumatology. Traffic accidents are the commonest cause, which accounts for the high peak of occurrence between 15 and 24 years of age. It is also worth noting that according to published series nearly 50% ofthe cases affect the thoraco-lumbar junction. From an anatomical point of view, we must note the severity of thoracic spinal cord lesions especially of the thoraco-lumbar junction and of the lumbar region and be able to associate injuries ofthe conus medullaris and of the ca uda equina where there is a possibility of neurological recovery. Clinical evaluation is not always easy, but remains the basis for diagnosis and prognosis. The neurological classification proposed by FRANKEL et al. in 1969 and used at STOKE MANDEVILLE Hospital seems to retain its value. A more sophisticated study of medullary evoked potentials, as described by TsUBOKAWA can allow a more precise localisation and appreciation of the extent ofthe lesion as well as a better evaluation ofthe prognosis and ofthe evaluation of treatment in the acute phase. The neuro-radiological study should include standard views ofthe whole of the spine with antero-posterior and lateral tomograms of the fractured or luxated area. At present, the unquestionable contribution of the CT.

Modern society is, to a great extent, characterised by a tremendous growth in transportation -- the freedom to travel is a central and fundamental human value. As mobility has increased so have health problems. The number of fatalities and serious injuries caused by road traffic is unacceptable, and, while a downward trend is visible in most countries, there still remains a lot to be done. This collection of contributions by scientists and administrators presents some of the latest findings in the area of mobility and its relation to medical treatment, rehabilitation, public health and prevention.

Hans von Holst Royal Institute of Technology, WHO Collaborating Center, Sweden Ake Nygren Karolinska Institute, WHO Collaborating Center, Sweden Ake E. Andersson Institute for Futures Studies, Sweden n a recent study initiated by Harvard University, World Bank and I World Health Organization it was concluded that road injuries will be ranked from number 9 today to number 3 within the next two to three decades if authorities all over the world do not pay more attention to this significant problem. Injuries in traffic do not only concern the patient himself but also the relatives from an emotional point of view and the society from a socio economic point. Both emerging markets and industrial countries have significant experi ence of the events following a traffic accident. Much effort has been directed towards transportation of the victim from the scene of the accident to intensive care unit in the hospital. Simultaneously, the awareness of our knowledge about how these injuries should be prevented is striking. The focus of this second book of transportation, traffic safety and health is to further present some of the latest aspects in the area of mobility and its rela tion to planning of an optimal traffic safety with respect to our present knowl edge in the field. The volume contains a collection of contributions presented of scientists, clinicians and administrators at The Second International Conference on Transportation, Traffic Safety and Health, held in Brussels, Belgium, 1996."

Trauma surgery has increasingly become a specialized field inspired by different principles and philosophy. A good trauma surgeon is a surgeon who knows how to perform abdominal vascular, thoracic, urologic, gynecologic, and orthopaedic procedures and is able to repair multiple traumatic injuries in the best sequence possible. In this first volume, practical, up-to-date guidance is provided on the optimal critical care and ICU management of trauma patients. In addition, individual chapters focus on specific injuries in orthopaedic trauma (and especially spinal trauma) and neurotrauma, with the aim of providing a fresh view of the surgical approach and practical suggestions for improving the skills of treating surgeons. Educational issues and the organization of a trauma center are also covered.

The volume will be a handy pocket guide for trainee surgeons and any surgeon, physician, or nurse who treats trauma patients. It will be particularly relevant for emergency department physicians, critical care and ICU doctors, orthopaedic surgeons, neurosurgeons, and professionals responsible for trauma care and decision making, programs of trauma education, or organization of a trauma center.

Also available: "Trauma Surgery" Vol. 2: Thoracic and Abdominal Trauma

Meniscal transplantation has become an attractive option in selected patients with incapacitating knee pain. This book discusses all aspects of meniscal transplantation, covering the use of both allografts and meniscal substitutes, including collagen and polyurethane implants. Acknowledged experts in the field review the basic science, explain indications, and describe surgical techniques and the results achieved to date. All the material is up to date, with information on new implants, new techniques, and new surgical approaches. Future trends in the treatment of meniscal lesions are also discussed as we move towards the application of regenerative strategies to restore meniscus function. "

The original AO/ASIF Instrumentation manual presented a concise and complete description of the AO instruments. Thoughtfully developed by Fridolin Sequin and Rigmor Tex hammar, the manual discussed in a clear fashion the purpose and care of the various AO instruments that are handled by the operating room staff. One important feature of the first edition was a detailed checklist of the instruments required for the more common operative procedures for treating fractures. Fridolin Sequin was well-suited to author the first edition: his 15 years of experience as a technical engineer for the AO gave him in-depth knowledge of AO instruments, and he drew on the clinical knowledge of Rigmor Texhammar, a consultant and di rector of the AO courses for nurses. Its original feature of com bining a column of text with a column of illustrations meant the manual quickly became accepted as a standard. By 1981, trans lations could be found in English, French, Spanish, and Italian. Not surprisingly, the manual was very popular."

Posttraumatic stump formation and replantation of the severed limb are both reconstructive plastic operations which may lead to the improvement or destruction of a patient's lifestyle. For the primary attending surgeon, the decision whether to undertake such an operation depends on the patient's clinical condition, the operational circumstances, the psychological and social aspects and, last but not least, on the surgeon's own abilities. This monograph is designed as a synopsis of the great number of patho-physiological parameters and surgical and rehabilitational aspects which must be considered in the analysis of complications in major limb replantation. In addition, basic information about the key role of ischemic myopathy and microangiopathy is supplied to encourage further experimental investigations.

and refinement that exists within the necessarily strict rules of the internal fixation method. In this way we seek to contribute to as weIl as to stimulate the search for rational solutions to surgical problems. It is assumed throughout that the reader is fa miliar with the technical fundamentals of internal fixation, and so these details are omitted. Instead, special indications and technical refinements are presented on the basis of case examples. Because an endless variety of situations can arise in orthopedic surgery (a circumstance that is attracting more and more surgeons to the field), we have taken ca re that our examples can readily be applied to novel situations. We now credit, in alphabetic order, those who contributed most to the techniques presented: R. BLATTER, A. BOITZY, C. BRUNNER, O. CECH, A. DEBRUNNER, F. MAGERL, G. SEGMUELLER, G. STUEHMER, and B.G. WEBER. We thus express thanks to those colleagues in our clinic who agreed to having their ideas published. But we are also grateful to our illustrators, H. and K. SCHUMACHER, our photographer, M. SCHAFFNER, and our chief secretary, U. OETLIKER, who contributed so much to the preparation of the manuscript. Finally, we thank Springer-Verlag for their patience with us and especiaUy for their efficient work in bringing the book to press. St. GaU, Fall 1981 CH.F. BRUNNER B.G. WEBER Contents Lag Screws ............. .

In bone surgery it is essential to compress fractures interfragmentarily in order to make them resistant to the tensile force of muscles and the force resulting from acceleration and deceleration. This can be best achieved by the use of cable tension bands as a traction mechanism. The cable tension band is - in terms of stability of fractures - far superior to the conventional rigid cerclage wire which has been widely used in osteosynthesis for over 100 years. The author explains the biomechanics of the tension band in detail. Theoretical findings are confirmed by clinical test results. All osteosynthetic techniques which can be carried out with cables are described giving details of operation instructions. Errors and risks are always pointed out. A reference book and operative manual at a time.

Ake Nygren Karolinska Institute, Sweden would like to welcome you on behalf of Karolinska Institute, I one of the organizers and initiators of this series of confer- ences on traffic safety. The conference we are opening today is the fourth in the series. Karolinska Institute is the largest medical university in Sweden. It is dedicated to improving health through research, educa- tion and dissemination of information and ideas. The series on traffic safety is one of the ways in which we are disseminating information and ideas on an international front. Karolinska Institute is 190 years old. The Medico Chirurgiska Institute was originally established in 1811 by royal decree after wars and cholera epidemics. In 1822, it became known by the name "Carolinska" . Amongst many other international endeavors, Karolinska Institute is perhaps best known for the nomination and appointments of Nobel Prize winners in medicine and physiology. Under the terms of Alfred Nobel's will, the prize winners are nominated and chosen by the Nobel Assembly of Karolinska Institute. During the hundred years that the prize has been in existence, several researchers from Karolinska Institute have become laureates. These are Hugo Theorell in 1955; Ragnar Granit in 1967; Ulf von Euler in 1970; and Sune Bergstrom and Bengt Samuelsson in 1982. In 1987, the medicine prize was awarded to Tonegawa from v Japan and in 1994 the literature prize was awarded to Oe Kenzaburo.