Surgical Care at the District Hospital
Part 1 2 3 4 5 6 Primary Trauma Care Manual

Surgical Care at the District Hospital provides a comprehensive guide to surgical procedures that are commonly performed at the district hospital. It is intentionally limited to emergency and very common problems and is not designed as a major textbook of surgery.

The manual is presented in seven parts with an initial section on organizing the district surgical service followed by clinical sections which include basic surgical procedures, the abdomen, emergency obstetrics, resuscitation and anaesthesia, acute trauma management and orthopaedics. It concludes with a course manual for teaching primary trauma care.

Using the manual
The manual is designed particularly for use by non-specialist clinicians, including:

:: District medical officers and other general practitioners working in isolation
:: Postgraduate medical officers (registrars)
:: Junior doctors
:: Medical students
:: Senior paramedical staff, including clinical officers and nurse anaesthetists
:: Medical and paramedical staff responsible for supervising the care and maintenance of equipment.

It should also be a valuable resource for:

:: Medical and paramedical personnel at secondary and tertiary levels, particularly those working in specialist areas, such as trauma care

:: Trainers in:
– Medical schools and university teaching hospitals
– Nursing schools
– Paramedical training institutions
– Continuing medical education programmes.

The evidence base for clinical practice
The interventions described in this manual are based on the latest available scientific evidence. It is planned to update it as new information becomes available but, since the evidence base for effective clinical practice is constantly evolving, you are encouraged to consult up-to-date sources of information such as the Cochrane Library, the National Library of Medicine database and the WHO Reproductive Health Library (see following page).

WHO would be pleased to receive comments and suggestions regarding the manual and experience in its use. This will be of considerable value in the preparation of future editions.

Sources for the evidence base for clinical practice
The Cochrane Library. Systematic reviews of the effects of health care interventions, available on diskette, CD-ROM and via the Internet. There are Cochrane Centres in Africa, Asia, Australasia, Europe, North America and South America. For information, contact: UK Cochrane Centre, NHS Research and Development Programme, Summertown Pavilion, Middle Way, Oxford OX2 7LG, UK. Tel: +44 1865 516300. Fax: +44 1865 516311.

National Library of Medicine:
An online biomedical library, including Medline which contains references and abstracts from 4300 biomedical journals and Clinical Trials which provides information on clinical research studies. National Library of Medicine, 8600 Rockville Pike, Bethesda, MD 20894, USA.

WHO Reproductive Health Library:
An electronic review journal focusing on evidence-based solutions to reproductive health problems in developing countries. Available on CD-ROM from Reproductive Health and Research, World Health Organization, 1211 Geneva 27, Switzerland.

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