Surgical care at the district hospital.

Format:

Book

Language:

English

Subjects (All):

Hospitals--Administration.

Surgery, Operative.

Obstetrics--Surgery.

Wounds and injuries--Surgery.

Anesthesia.

Physical Description:

1 online resource (514 pages)

Edition:

1st ed.

Place of Publication:

Geneva : World Health Organization, 2003.

Language Note:

English

Summary:

Many patients who present to district (first-referral) level hospitals require surgical treatment for trauma, obstetric, abdominal or orthopedic emergencies. Often surgery cannot be safely postponed to allow their transfer to a secondary or tertiary-level hospital but many district hospitals in developing countries have no specialist surgical teams and are staffed by medical, nursing, and paramedical personnel who perform a wide range of surgical procedures often with inadequate training. The quality of surgical and acute care is often further constrained by poor facilities, inadequate low-technology apparatus and limited supplies of drugs, materials, and other essentials. The mission of the team responsible for Clinical Procedures in the World Health Organization Department of Essential Health Technologies (EHT) is to promote the quality of clinical care through the identification, promotion and standardization of appropriate procedures, equipment and materials, particularly at district hospital level. WHO/BCT has identified education and training as a particular priority, especially for non-specialist practitioners who practice surgery and anesthesia. It has therefore developed Surgical Care at the District Hospital as a practical resource for individual practitioners and for use in undergraduate and postgraduate programs in-service training and continuing medical education programs. The manual is a successor of three earlier publications that are widely used throughout the world and that remain important reference texts: General Surgery at the District Hospital (WHO 1988), Surgery at the District Hospital: Obstetrics Gynecology Orthopedics and Traumatology (WHO 1991), Anesthesia at the District Hospital (WHO 1988; second edition 2000). This new manual draws together material from these three publications into a single volume which includes new and updated material, as well as material from Managing Complications in Pregnancy and Childbirth: A Guide for Midwives and Doctors (WHO 2000).

Contents:

Intro

Contents

Preface

Acknowledgements

Introduction

PART 1: ORGANIZING THE DISTRICT HOSPITAL SURGICAL SERVICE

1 Organization and management of the district surgical service

1.1 The district hospital

1.2 Leadership, team skills and management

1.3 Ethics

1.4 Education

1.5 Record keeping

1.6 Evaluation

1.7 Disaster and trauma planning

2 The surgical domain: creating the environment for surgery

2.1 Infection control and asepsis

2.2 Equipment

2.3 Operating room

2.4 Cleaning, sterilization and disinfection

2.5 Waste disposal

PART 2: FUNDAMENTALS OF SURGICAL PRACTICE

3 The surgical patient

3.1 Approach to the surgical patient

3.2 The paediatric patient

4 Surgical techniques

4.1 Tissue handling

4.2 Suture and suture technique

4.3 Prophylaxis

5 BASIC SURGICAL PROCEDURES

5.1 Wound management

5.2 Specific lacerations and wounds

5.3 Burns

5.4 Foreign bodies

5.5 Cellulitis and abscess

5.6 Excision and biopsies

PART 3: THE ABDOMEN

6 Laparotomy and abdominal trauma

6.1 Laparotomy

6.2 Abdominal trauma

7 Acute abdominal conditions

7.1 Assessment and diagnosis

7.2 Intestinal obstruction

7.3 Peritonitis

7.4 Stomach and duodenum

7.5 Gallbladder

7.6 Appendix

8 Abdominal wall hernia

8.1 Groin hernias

8.2 Surgical repair of inguinal hernia

8.3 Surgical repair of femoral hernia

8.4 Surgical treatment of strangulated groin hernia

8.5 Surgical repair of umbilical and para-umbilical hernia

8.6 Surgical repair of epigastric hernia

8.7 Incisional hernia

9 Urinary tract and perineum

9.1 The urinary bladder

9.2 The male urethra

9.3 The perineum

PART 4: EMERGENCY OBSTETRIC CARE

10 Hypertension in pregnancy

10.1 Hypertension

10.2 Assessment and management

10.3 Delivery

10.4 Postpartum care.

10.5 Chronic hypertension

10.5 Complications

11 Management of slow progress of labour

11.1 General principles

11.2 Slow progress of labour

11.3 Progress of labour

11.4 Operative procedures

12 Bleeding in pregnancy and childbirth

12.1 Bleeding

12.2 Diagnosis and initial management

12.3 Specific management

12.4 Procedures

12.5 Aftercare and follow-up

PART 5: RESUSCITATION AND ANAESTHESIA

13 Resuscitation and preparation for anaesthesia and surgery

13.1 Management of emergencies and cardiopulmonary resuscitation

13.2 Other conditions requiring urgent attention

13.3 Intravenous access

13.4 Fluids and drugs

13.5 Drugs in resuscitation

13.6 Preoperative assessment and investigations

13.7 Anaesthetic issues in the emergency situation

13.8 Important medical conditions for the anaesthetist

14 Practical anaesthesia

14.1 General anaesthesia

14.2 Anaesthesia during pregnancy and for operative delivery

14.3 Paediatric anaesthesia

14.4 Conduction anaesthesia

14.5 Specimen anaesthetic techniques

14.6 Monitoring the anaesthetized patient

14.7 Postoperative management

15 Anaesthetic infrastructure and supplies

15.1 Equipment and supplies for different level hospitals

15.2 Anaesthesia and oxygen

15.3 Fires, explosions and other risks

15.4 Care and maintenance of equipment

PART 6: TRAUMATOLOGY AND ORTHOPAEDICS

16 Acute trauma management

16.1 Trauma in perspective

16.2 Principles of Primary Trauma Care

16.3 Six phases of Primary Trauma Care

16.3 Procedures

17 Orthopaedic techniques

17.1 Traction

17.2 Casts and splints

17.3 Application of external fixation

17.4 Diagnostic imaging

17.5 Physical therapy

17.6 Cranial burr holes

18 Orthopaedic trauma

18.1 Upper extremity injuries

18.2 The hand.

18.3 Fractures of the pelvis and hip

18.4 Injuries of the lower extremity

18.5 Spine injuries

18.6 Fractures in children

18.7 Amputations

18.8 Complications

18.9 War related trauma

19 General orthopaedics

19.1 Congenital and developmental problems

19.2 Bone tumours

19.3 Infection

19.4 Degenerative conditions

ANNEX

Primary Trauma Care Manual: Trauma Management in Remote and District Locations

Index

A

B

C

D

E

F

G

H

I

J

K

L

M

N

O

P

Q

R

S

T

U

V

W

X.

Notes:

Bibliographic Level Mode of Issuance: Monograph

ISBN:

1-280-04148-X

9786610041480

92-4-068442-5

92-4-068137-X

OCLC:

476034724