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Front Line Surgery

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Front Line Surgery
As you step off the plane you are struck by an oppressive heat, but this is not what catches your attention. It is the foreignness of this place – the unfamiliar terrain, the
noise, the oddly clustered tents and buildings, the serious and determined looks of people involved in a war. I had completed a trauma fellowship at one of the busiest penetrating trauma centers in the U.S. and thought I was ready for anything; mistake number one. Fortunately you have at least several days of overlap with the outgoing group of surgeons that you are replacing. I first met the surgeon I was replacing in a dusty tent in Tikrit, Iraq. Luckily for me it was Marty Schreiber, one of the best trauma surgeons I know.
His last and most important task at the end of his combat tour was to pass on everything a new and inexperienced combat surgeon needed to know to survive and thrive in this environment. Over the next 72 hours I received a mini-fellowship in forward medicine and combat trauma surgery. After that, the first month was an eye opening crash course in how to manage a constant stream of the most severely injured patients you will ever see.


1. Prehospital and Enroute Care
2. Combat Triage and Mass Casualty Management
3. Initial Management Priorities: Beyond ABCDE
4. Damage Control Resuscitation
5. To Operate or Image? (Pulling the Trigger
6. Ultrasound in Combat Trauma
7. The Bowel: Contamination, Colostomies, and Combat Surgery
8. Liver and Spleen Injury Management in Combat (Old School)
9. Pancreatic and Duodenal Injuries (Sleep When You Can…)
10. Operative Management of Renal Injuries
11. Major Abdominal Vascular Trauma
12. To Close or Not to Close: Managing the Open Abdomen
13. Choice of Thoracic Incision
14. Lung Injuries in Combat
15. Diagnosis and Management of Penetrating Cardiac Injury
16. Thoracic Vascular Injuries: Operative Management in “Enemy” Territory
17. Chest Wall and Diaphragm Injury
18. Soft Tissue Wounds and Fasciotomies
19. Extremity Injuries and Open Fractures
20. Mangled Extremities and Amputations
21. Peripheral Vascular Injuries
22. The Neck
23. Genitourinary Injuries (Excluding Kidney)
24. Neurosurgery for Dummies
25. Spine Injuries
26. Face, Eye, and Ear Injuries
27. Burn Care in the Field Hospital
28. The Pediatric Patient in Wartime
29. The Combat ICU Team
30. Postoperative Resuscitation
31. Monitoring
32. Ventilator Management
33. Practical Approach to Combat-Related Infections and Antibiotics
34. Stabilization and Transfer from the Far Forward Environment
35. Humanitarian and Local National Care
36. Expectant and End of Life Care in a Combat Zone

Title: Front Line Surgery
Author: Matthew Martin, Alec Beekley
Language: English


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