Expeditionary Surgery at Sea

Book excerpt: Currently, no comprehensive practical surgical textbook or other reference exists for the management of injured and other surgical patients at sea. This text focuses on the increasingly important field of medical and surgical management of patients in the modern expeditionary maritime environment. The editors and contributors to this new handbook are a group of physicians, nurses, and corpsmen with extensive experience in caring for patients in the expeditionary maritime environment, designing and implementing current doctrine and policy, and publishing peer-reviewed articles focused on these topics. This handbook takes the approach of a "how to" manual for the management of combat or disaster victims, beginning at the point of injury and proceeding through each stage of care until they leave the maritime environment. This includes sections on prehospital care, triage, en-route care, and maritime mass casualty management, as well as additional chapters covering unique aspects of maritime platforms, capabilities, and missions. The bulk of the book focuses on the initial patient evaluation and resuscitation as well as the operative and perioperative phases of care including prolonged casualty care. The primary focus throughout the book is on simple, practical, and proven practices that can be easily understood and implemented by physicians and independent providers of any experience level who may find themselves in similar situations. For the clinical chapters, each begins with a clinical vignette relevant to the chapter based on actual patients or maritime scenarios experienced by the authors demonstrating the various challenges that can occur caring for injured and surgical patients at sea while deployed on maritime and amphibious platforms. When appropriate, each clinical chapter will conclude by describing the recommended management and outcome of the patient(s) presented in the vignette that opened the chapter. The style is plain and direct language, avoiding scientific jargon and unnecessary complexity whenever possible. Each chapter begins with 5 to 10 bullet points that summarize the key information or “BLUF” (bottom line up front) from that chapter and conclude with common tips and pitfalls, as well as recommended high-yield resources for the entire maritime surgical team.