创 伤
1.Death and taxes are the two most quoted inevitabilities of life; trauma qualifies as a legitimise third.
—— Alexander J.Walt, 1923——1996
【译文】死亡和纳税是人们一生中最常提到的，不可避免的两件大事，创伤则有资格被认定为第三件。
2.Trauma is the motor end plate of violence.
—— Claude H.Organ
【译文】创伤是暴力的运动终板。
3.One set of vital signs isn't "hemodynamically stable".
【译文】“生命体征”那组参数并不能代表“血流动力学稳定”。
4.Shock from severe wounds and hemorrhage always must take precedence of everything else.
—— William W.Keen, 1837——1932
【译文】严重创伤和出血引起的休克是压倒一切的重要事情。
5.It is absolutely necessary for a surgeon to search the wound himself, which were not drest by him at first, in order to discover their nature and know their extent.
—— Augustine Belloste, 1645——1730
【译文】外科医生必须亲自查验那些最初并非由他经手处理的伤口，以便弄清楚伤口的性质及其严重程度。
【点评】获得第一手的伤口局部情况有助于后续的各种处理。
6.Wounds in the joints are always dangerous.
—— John Ranby, 1703——1773
【译文】关节处的伤口总是危险的。
7.Splint them where they lie.
—— Anthony A.Bowlby, 1855——1929
【译文】让他们躺在原地不动用夹板来固定。
【点评】这是对多处骨折患者的重要救治原则，尤其是高位颈椎骨折患者。
8.A gunshot wound is often not completely understood at first, for it is at first,in many cases, impossible to know what parts are killed ...till the deadened part has separated, which often makes it a much more complicated wound than at first was known or imagined.
—— John Hunter, 1728——1793
【译文】初期，我们通常并不完全了解枪伤的伤情，因为许多情况下，一开始不可能知道究竟伤及了哪些部分……直到失活的组织分离开来，这往往比最初所见或想象的要复杂得多。
【点评】枪伤伤情判断的经验之谈。
9.On fistula from an injured abdominal viscus: this new symptom, although in general very disagreeable, will not be dangerous, for all the danger is over before it can appear.
—— John Hunter, 1728——1793
【译文】关于腹部空腔脏器伤所导致的瘘管：出现这种新情况时，通常会令人不舒服，但并不危险，因为所有的危险在瘘形成前就已经结束了。
【点评】说得很对，瘘的形成是病变局限、受控的结果。
10.Exploratory laparotomy offers, in our judgment, the quickest and the safest method of positive diagnosis.The emergency warrants a decisive step.
—— Albert Miles, 1893
【译文】以我之见，剖腹探查术是最快、最安全、最确切的诊断手段。紧急情况有必要采取果断措施。
【点评】100多年过去了，很多情况下，尤其是紧急情况下，剖腹探查依然具有其不可替代的价值。
11.Though shock may be temporarily alleviated by transfusion, it cannot be arrested or overcome; resuscitation divorced from surgery is folly.
—— William Heneage Ogilvie, 1887——1971
【译文】输血可以暂时缓解休克，但不能阻断或控制休克；离开了手术的复苏是愚蠢的。
【点评】只有通过手术彻底控制导致失血性休克的源头才有复苏的基础。
12.In any emergency setting, confusion is a function of the cube (N3)of the number of people involved.
—— Clement A.Hiebert
【译文】在任何紧急情况下，混乱程度是参与人数的立方。
13.Definition of a heavy trauma: somebody who arrives at the hospital in more than one ambulance.
—— John Edwards(https://www.daowen.com)
【译文】严重创伤的定义：不止一辆救护车送达医院的伤员。
14. He should have a special love for the wounded persons as for his own body.
—— Hans von Gersdorff, 1480——1540
【译文】他应该像珍惜自己的身体一样给伤者以特别的关爱。
15. Failure to promptly recognize and treat simple life-threatening injuries is the tragedy of trauma, not the inability to handle the catastrophic or complicated injury.
—— F.William Blaisdell
【译文】创伤的悲剧是那些未能及时识别和处理的，危及生命的简单伤，而不是那种无法处理的灾难性或复杂伤。
16. That's why you call these forms of transportation donor cycles in Kentucky, where helmets are optional.
—— Karen Draper
【译文】这就是为什么在肯塔基州，人们把摩托车这种交通工具称为“捐献者摩托”的原因，在那里戴头盔不是强制性的。
【考注】Donorcycle最初起源于急诊室医生的说法，他们看到太多死于摩托车交通事故的患者。国内也有“夺命摩托”之说。
17.In urban trauma "scoop and run" is better than "stay and play".
【译文】对于发生在城市的创伤，“抱起来就送”比“就地处理”要好。
【考注】“Scoop and run”：“抱起来就送”或者称“无干预转运”是院前创伤救治的一种基本形式。2014年的一项研究发现，与等待救护车的患者相比，使用私人交通工具运送患者的存活率有所提高。因此，提倡当伤者的病情严重到没有足够的时间完成常规医疗稳定流程和（或)救护车或直升机内没有拯救患者生命所需设备和专家时就应“抱起来就送”。但也有研究认为对“心脏骤停”患者似乎“Stay and Play（就地处理）”好于“抱起来就送”[Deakin C.D.(2003) https://doi.org/10.1007/978-88-470-2215-7_31]
18. Doubt as to the condition of the wound should incline one to pessimism rather than to mistaken optimism.
—— William Heneage Ogilvie, 1887——1971
【译文】对伤口状况的怀疑应该倾向于悲观，而不是错误的乐观。
19. Simple closure of a wound of the colon, however small, is not warranted.
—— William Heneage Ogilvie, 1887——1971
【译文】单纯关闭结肠伤口，无论大小，都是不保险的。
【点评】很多基层的年轻外科医生不懂这条原则。
20. A severe pelvic fracture is to be respected -there is little a surgeon can do to stop the bleeding, but much that can be done to make the bleeding worse.
—— Avery B.Nathens
【译文】严重的骨盆骨折是值得重视的——虽然外科医生几乎没有什么办法止血，但却可做很多使出血变得更糟的事。
【点评】面对“严重的骨盆骨折”，外科医生少做好于多做。
21.(Shock)… momentary pause in the act of death.
—— John Collins Warren, 1778——1856
【译文】（休克）……是死亡行为的短暂停顿。
22.(Shock): The manifestation of the rude unhinging of the machinery of life.
—— Samuel Gross, 1805——1884
【译文】（休克）：是生命机器野蛮死机的表现。
23.Wounds of the liver are very serious and despite most energetic treatment,the outcome is often regrettable.
—— Guillaume Dupuytren, 1777——1835
【译文】肝脏伤是非常严重的创伤，尽管给予了最积极的治疗，但结果往往令人遗憾。
【点评】那是因为那个年代我们对肝脏解剖和病理生理了解太少。
24. An injury to the head is never so slight as to be despised, and never so severe as to be despaired of.
—— Hippocrates, 460——377 BC
【译文】头部伤从来不会轻到让人置之不理，也不会重到让人绝望。
【点评】那个年代有底气说这种话，我想应该是指那些不会危及生命的头面部伤。
25. Physicians have to act not only in the cities, in the field, and in the desert places, but also at sea in ships, where such diseases sometimes suddenly break out.
—— Paul of Aegina, 625——690
【译文】医生不仅要在城市、田野和荒漠地区行医治病，而且也会在海上的船舰上履职，因为有时在海上会突然暴发某种疾病。
【点评】历史上确有不少疾病在行驶的海船上暴发，尤其是呼吸系统传染病。比如，最近发生的COVID-19。