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HURT
The Inspiring, Untold Story of Trauma Care
by
Catherine Musemeche, M.D.
Genre: Medicine / Medical History
Date of Publication: September 6, 2016
Publisher: ForeEdge
# of pages: 268
Synopsis

The heroic story of the invention of trauma care, from  battlefield triage to level 1 trauma centers Trauma is a disease of epidemic proportions that preys on the young, killing more Americans up to age thirty-seven than all other afflictions combined. Every year an estimated 2.8 million people are hospitalized for injuries and more than 180,000 people die.

We take for granted that no matter how or where we are injured, someone will call 911 and trained first responders will show up to insert IVs, stop the bleeding, and swiftly deliver us to a hospital staffed by doctors and nurses with the expertise necessary to save our lives. None of this happened on its own.

Told through the eyes of a surgeon who has flown on rescue helicopters, resuscitated patients in trauma centers in Houston and Chicago, and operated on hundreds of trauma victims of all ages, Hurt takes us on a tour of the advancements in injury treatment from the battlefields of the Civil War to the state-of-the-art trauma centers of today.

PRAISE FOR HURT: THE INSPIRING, UNTOLD STORY OF TRAUMA CARE

“Musemeche’s fast-paced medical history mixes the gritty reality of treating life-threatening injuries—including her own heart-pounding experiences as surgeon—with an unfettered optimism about what trauma care can now promise: an assurance that most people will survive even a devastating injury.”

—Publishers Weekly

“Hurt is a fascinating journey through the history of trauma care in this country. Musemeche’s unique ability to weave moving, personal stories with intriguing facts takes this book well beyond a great read. It is an education in the human spirit.” —Paul Ruggieri, MD, author of Confessions of a Surgeon and The Cost of Cutting


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GuestPost

“Expanding the Golden Hour”
Guest Post
by Catherine Musemeche, M.D.

R. Adams Cowley of Maryland Shock Trauma was the first to describe “the golden hour,” the critical hour after injury during which action must be taken to save a patient’s life. Treatment of injury is time-sensitive. Patients must be treated in that first hour after injury, before they bleed out and before the body’s predetermined biological processes set the scene for shock to take hold. 

But getting a patient to a hospital within that first hour is not always possible and when it’s not we need to think of ways to expand the golden hour, to give our patients their best chances of survival in the field. Nowhere has this been better demonstrated than on the battlefield, particularly in the last decade of war. 

One of the best ways to expand the golden hour and buy time for a patient in the field is to stop the bleeding. Military doctors found that most combat casualties die within ten minutes of being wounded and usually from exsanguination. Tourniquets had fallen out of favor during World War II and Vietnam over concerns about choking off the blood supply to a damaged limb but they have made a comeback because of concerns over fatal hemorrhage. 

The Combat Application Tourniquet (CAT) is a simple tourniquet that can be applied by a wounded soldier using only one hand. Applying a tourniquet before a patient goes into shock can improve survival by 90 percent. Tourniquets have been so effective in combat that the CAT is becoming part of standard civilian EMS procedure again and even some police are carrying them.

Other ways to expand the golden hour include using hemostatic bandages like QuikClot Combat Gauze, bandages impregnated with kaolin, an agent that accelerates the body’s own clotting mechanisms. There is even a way to stem suspected internal bleeding. The XStat, the “medical version of Fix-a-Flat,” is a syringe filled with small spongelike discs impregnated with a clotting agent. The syringe can be deployed into an open wound like a bullet hole in the abdomen to help tamponade internal bleeding. 

These hemorrhage control measures will only buy so much time for the injured. When effective, however, they might just delay the onset of shock and expand the golden hour sufficiently to save the patient. 

More on bleeding and R Adams Cowley in Chapters 6 & 7 of HURT: the inspiring, untold story of trauma care.

about the author

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Dr. Catherine Musemeche is a pediatric surgeon, attorney and author who lives in Austin, Texas. She was born and raised in Orange, Texas and attended Lutcher Stark High School. She is a graduate of the University of Texas in Austin, The University of Texas McGovern Medical School in Houston, The Anderson School of Management in Albuquerque, New Mexico and The University of Texas School of Law in Austin, Texas. Dr. Musemeche is a former surgery professor at the University of Texas Medical School in Houston, the MD Anderson Hospital and Tumor Institute and the University of New Mexico where she was the Chief of Pediatric Surgery and Pediatric Trauma. She currently works in the field of regulatory medicine.

In addition to publishing extensively in the medical literature, Dr. Musemeche has been a guest contributor to the New York Times. Her writing has also been published on NPR.org, KevinMD.com, in the anthology At the End of Life: True Stories About How We Die and in the Journal of Creative Nonfiction. Her first book, Small: Life and Death on the Front Lines of Pediatric Surgery was nominated for the Pen American/E.O. Wilson Literary Science Award and was awarded the Writer’s League of Texas Discovery Prize for nonfiction. Her second book, Hurt: The Inspiring, Untold Story of Trauma Care will be published in September of this year.

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