Features concisely written, practical knowledge written by veterans of combat surgery
Offers a large number of full-color images that illustrate difficult techniques and situations
Provides the most necessary and practical knowledge needed by surgeons working on the front lines
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.


Table of 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