Handbook of Trauma.
Article Type: Book review
Subject: Books (Book reviews)
Author: Surridge, Daniel
Pub Date: 11/01/2011
Publication: Name: South African Journal of Surgery Publisher: South African Medical Association Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2011 South African Medical Association ISSN: 0038-2361
Issue: Date: Nov, 2011 Source Volume: 49 Source Issue: 4
Topic: NamedWork: Handbook of Trauma, 2d ed. (Nonfiction work)
Persons: Reviewee: Nicol, Andrew; Steyn, Elmin
Accession Number: 280557383
Full Text: Handbook of Trauma. 2nd ed. By Andrew Nicol and Elmin Steyn. Pp. xii + 514. Illustrated. R389.95. Oxford University Press Southern Africa, 2010. ISBN 9780-0-19-598747-8.

Trauma is an illness that affects our entire society. It places a burden on all levels of medical care, from the office health and safety officer, through the paramedic, nurse and doctor, all the way to government policymakers. For this reason, it places significant financial and emotional strain on healthcare systems. The South African experience of trauma is unique, as it combines the resource rich with the resource poor; huge distances with inaccessible areas; public awareness with a society that promotes risk-taking behaviour ...

The Handbook of Trauma was first published in 2004 and set out to give South African health care practitioners a manual relevant to this unique situation, in which we are all too often lost. As we better understand the disease of trauma and best practice for care of these patients has changed, a revised second edition has been released (2010). Once again, experts in the field have contributed to give the most relevant information available. New chapters have been added to make the book even more comprehensive.

The book is divided into 6 parts, starting with a basic skeleton giving an approach to a general trauma patient. From here, it adds flesh to these bones and provides a basic theoretical understanding with a practical emphasis. Each chapter is rich in functional tips and pitfalls.

Part 1 takes the trauma patient from the road into the emergency area. Aspects of prehospital care and disaster management are explored before moving on to a structured resuscitation. Easy mnemonics are suggested so that a systematic approach may be employed. These include what to do when the patient deteriorates despite best efforts. Sensible use of investigations and pain control are discussed, giving practical applications for both (even when resources are limited).

Part 2 takes one through the secondary survey from head to toe, grading injuries and giving practical advice on how to treat them. The patient is taken from the emergency room to the operating theatre and on to the intensive care unit or ward. Management of sexual assault, which is often overlooked in the secondary survey, is also described. Specific cases are dealt with in parts 3 and 4. These cover the extremes of age, pressure, pregnancy, HIV, thermal trauma, high-energy injury and poisonous bites. All of these are common presentations of trauma patients that deserve special attention.

General ICU care for the trauma patient is covered in part 5. Among other aspects, prevention and management of common complications are dealt with. The often neglected area of psychological trauma is brought to the fore to remind the reader that injury affects the human being as a whole and is not just an illness. Part 6 gives academic input, describing trauma scores and systems as well as touching on the medico-legal side. Information on end-of-life decisions and organ donation according to South African law can be found in the final chapter.

Many South African medical students and housemen entering a casualty area for the first time are intimidated by the critical nature of trauma cases and the speed with which medical staff must act. This book fits easily into the pocket of a white coat and can explain situations faced by many for the first time.

The practice of trauma medicine cannot be demonstrated by a single book. South African health workers dealing with injured patients must be resourceful and deal with the situations in which they find themselves and their patients. The 2nd edition of Oxford University Press Southern Africa's Handbook of Trauma provides a solid grounding in the approach to trauma patients for all heath care practitioners who treat them. It is also an excellent reference for the student, intern, medical officer or registrar finding him- or herself in a position that requires a new tactic or better understanding. In short, this book is an essential weapon in the armamentarium of any South African doctor who deals with trauma, and no casualty department should be without one.

Daniel Surridge

Senior Surgical Registrar

University of the Witwatersrand
Gale Copyright: Copyright 2011 Gale, Cengage Learning. All rights reserved.