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Bumpy Design, book design

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Bumpy Design: freelance book design and composition, portfolio and services.

Bumpy Design: freelance book design and composition, portfolio and services.

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  • If you like scrapbooking, then you're gonna love this:
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    Bumpy Design, book design Bumpy Design, book design Presentation Transcript

    • book design + composition
    • book cover design
    • book design + composition kim scott / kim@bumpy.com / www.bumpy.com “ DeSPIte My DoUBtS, I crouched down about 3 or 4 feet in front of one of the A D o B E® M A S t E r C L A S S happily munching steers. As the rancher began to swing her empty grain sack, I began to shoot. the startled steer lurched past me and I fell onto my butt— a process we repeated about 30 times with different animals. But we got our ” ADoBE MAStEr CLASS PhotoShoP CoMPoSItIng® shots. After that, we put a leaf blower into the dirt road and shot more film of the resulting dust clouds. Back in the studio, we Pen-tooled about 15 of the cattle and began to copy and paste them into a single image. then began the exciting with John Lund part—working with layer masks… Adobe Photoshop Compositing with the Master “John Lund is special in the way he John Lund is one of the world’s most successful creators of digitally channels his insane energy through manipulated images. In this book, you’ll see how Lund makes PhotoShoP CoMPoSItIng Photoshop to bring you ideas that the extraordinarily complex images using remarkably simple techniques. sane mind may never have imagined.” Part One offers an overview of Lund’s approach to gathering images and putting together a memorable composite. Part Two takes you step Russell PReston BRown, Sr. CreAtIve DIreCtor, ADoBe SySteMS InC. by step through the process of creating twelve of Lund’s best-selling images. Every step of the way, Lund offers key lessons, preferences, “Anyone can learn how to composite and tricks he’s learned in years of daily work with Photoshop. Each photographs in Photoshop, but it takes chapter offers: someone like John Lund to express the joy and freedom of digital image • A breakdown of the elements that make up the finished piece making.” • Annotated illustrations of the compositing process Julieanne Kost, PhotoShoP evAngeLISt, • A step-by-step guide to how Lund uses a particular Photoshop ADoBe SySteMS, InC. technique in the making of the image “I love John’s work, and to be able to see step by step how his evil little mind Pamela Pfiffner, editor-in-chief of Creativepro.com and author of Inside works when creating his magic is really the Publishing Revolution: The Adobe Story, provides an exclusive peek wonderful.” at Lund’s creative process, narrating it and translating it into colorful andRew Rodney, DIgItAL Dog information graphics and step-by-step lessons. You’ll learn how to: “John Lund is one of the great pioneers • Gather a library of “parts” of the digital image; he forged an • Use the Liquify filter to transform reality approach and style that has influenced • Master shadows and highlights to fool many. As this book shows, it is his with anyone into thinking a fabricated image devotion to getting the details right is real that gives his pictures the extra depth John Lund to resonate and connect.” • Make layer masks your most powerful ally • Hide joins and control lighting to meld parts into lewis BlacKwell, SenIor vICe PreSIDent of CreAtIve DIreCtIon, getty IMAgeS a seamless whole • Make images seem super-realistic—or wildly fantastical Simple techniques for making magic in Adobe Photoshop US $50.00 Lund Canada $75.99 / UK £37.99 Pfiffner www.AdobePress.com Adobe Press books are Book Level: Intermediate / Advanced published by Peachpit Press Computer Book Shelf Category: 1249 Eighth Street • Berkeley, CA 94710 Graphic Design / Photoshop / Digital Imaging 800-283-9444 • 510-524-2178 Cover Design: Kim Scott JoHn LUnD and PAMELA PfIffnEr fax 510-524-2221 • www.peachpit.com Cover Illustration: John Lund
    • book design + composition kim scott / kim@bumpy.com / www.bumpy.com Kenneth A. Olson Companion DVD Inside Manual Physical Therapy of the Spine Manual Physical Therapy of the Spine Olson Companion DVD Inside Olson_cover_finalCS3.indd 1 3/7/09 3:09:14 PM
    • book design + composition kim scott / kim@bumpy.com / www.bumpy.com
    • book design + composition kim scott / kim@bumpy.com / www.bumpy.com
    • book design + composition kim scott / kim@bumpy.com / www.bumpy.com
    • book interior design
    • book design + composition kim scott / kim@bumpy.com / www.bumpy.com the Hot shoe diaries, by Joe McNally 2009 New Riders / interior design assistance, template setup, custom composition
    • book design + composition kim scott / kim@bumpy.com / www.bumpy.com creative digital scrapbooking 2005 Peachpit Press / interior design, template setup, custom composition chapter 2 College Memories Scrapbook talents, she explored her own. Not long ago, Barbara Creative Possibilities decided to begin to compile a book of her great- Okay, so think back to your college days. What do In this chapter grandmother’s mouth-watering recipes, and her you wish you could have captured? Whether your memory cookbook quickly turned into a scrapbook college years were about friends and fun or studies as she placed recipes, images, stories, and clippings and seriousness, there were sure to be memorable EMBELLISHMENTS Choose Your Story The Big Picture: ❋ on her pages (see Figure 2.12). times that include important stories about who you No matter what type of scrapbook you’re creating, Exploring Scrapbook Types were and who you have become. A college memories ❋ A cookbook scrapbook provides so much more you can enhance the authenticity of the experience by Plan Your Scrapbook scrapbook might collect important events or chron- than family recipes—it could show the relationships adding items from real life. If you have a scanner and Plan the Particulars ❋ icle deep friendships; you could include bits of the among people in your family; it could chronicle the digital image-editing software, you might want to scan yearbook, quotes from friends; hopes for the future; Set the Date these or other items that are related to the stories ❋ changes from generation to generation; it could CD covers (unless you went to college in the ’70s you want to tell in your scrapbook pages: include trivia and nostalgia, and provide the history Gather Your Tools ❋ or before, and then you’ll have to scan old albums); behind family traditions. (“I’ve always wanted to Recipe cards Airplane tickets headlines; photos of celebrities. There are so many know, Grandpa—why does our family make meat- Create Your Workspace ❋ possibilities. balls with hard-boiled eggs in the middle?”) Sticky notes Bits of fine ribbon WHEN YOU’RE BEGINNING any new creative The college years—and a college memories Wedding invitations Business cards T P I scrapbook—are all about hope; preparing for a project, it’s always a good idea to start with Wedding rings Colorful fabric future; learning about your abilities; discovering who If you want the family cookbook to be used as a you are. Your scrapbook could tap into that sense of the end in mind. What story, or stories, will Yearbook photos Favorite cereal real cookbook today, you might look into ways hope by doing “then and now” pages, where you tell to modernize some of the old recipes by looking Jelly beans your scrapbook tell? How do you want it to look? the story of a special friend from that time and coun- for low-fat and low-cholesterol alternatives. These recipes might not be as decadent as southern-fried ter it on the facing page with the story of that friend Lace Which tools will you use, and when do you want chicken, homemade biscuits, and gravy, but they today, with journaling to describe what she’s doing FIGURE 2.12 Barbara’s heritage scrapbook captures might be healthy enough that you’ll feel like you can Leaves now and what’s important to her. her grandmother’s renowned recipes and tells the stories your scrapbook to be finished? Whether you are eat them more often, revisiting an important part of of her life. your family’s heritage. Letters College memories will be as different as the people capturing a year in the life of your family or telling who remember them, so be sure to get in touch with Maps stories about that wonderful week in Fiji, knowing your own feelings about your college days. They’ll Family Events Scrapbook Matchbooks make the scrapbook pages you create that much what you want to accomplish in your first project is richer. A family events scrapbook could include significant family events that Menus occur over time. Examples might be a move to a new house, re-land- the vision that will guide you as you create. Napkins scaping the yard, the arrival of the baby grand piano, running in a mini- Cookbook marathon, or winning a new car at the state fair. Pebbles Barbara is a wonderful cook and she’s learned only recently that her great-grandmother started a cater- Of course, your family events might include some sad happenings, too, Postcards ing business in her home during World War I. As such as the loss of a pet, the big flood of 2003, your mother’s cancer Barbara learned more about her great-grandmother’s treatment, or the struggle of looking for a new job. You might wonder 27 42 43 CHAPTER 2 The Big Picture: Plan Your Scrapbook You Do It! Ask the Expert 9. 6. Q What was hardest for you as a new designer? importance, sometimes you can join them and make them Add enhancements. You might want to add Rename layers. Each What came easiest? one. For example, say you have a photo that is the key a drop shadow, a special effect, or a lighting image you add is to your page, but without the text, you don’t understand enhancement to the images or the text items given its own layer A The hardest thing for me was creating designs that “Every page has a most important the photograph. To solve this, you can use your image edi- The Digital Scrapbooking Process: you added. You can experiment with the differ- in the image file. In appealed to people who weren’t like me. I needed element. The challenge is to find WHAT YOU NEED: AREN HOWELL, GRAPHIC DESIGNER tor to integrate the text into the image so that parts of Start to Finish ent options (you’ll learn how throughout this to learn to step into someone else’s shoes and ask myself it and design the page around the Layer palette on • Paint Shop Pro or another image- the image show through the text. That way, the elements Aren Howell has been a graphic designer for more what was going to keep them in the page. Typography what’s going to get the most book), but be sure you know how to Undo your the right side of the editing program of your choosing become one piece… the eye picks up both at one glance. than 12 years, designing book covers, marketing materials, comes easiest to me. It’s something I really love. There’s attention.” last change. In Paint Shop Pro, open the Edit Depending on how much time and creative energy you have, you may screen, right-click the • Digital photos downloaded from and “just about anything you can imagine,” for publishers an art to it, knowing when to use a simple readable font menu and choose Undo. choose to create your digital scrapbooks in one of two ways. If you have layer of each image your camera or scanner and other companies all over the country. Aren has also and when to push the envelope using a display face. a digital scrapbooking program that includes templates, you can sim- and choose Rename; 10. • Special paper or texture back- people. I think that’s how I learned to lay type out on Add embellishments. This is where you’ll been a contributing author to two Photoshop books, and grounds (or you can create your ply insert your own images and text in the ready-made layout. If you’re enter a name that describes the image so you Q the page. What words of advice would you give someone her work has been recognized in Print’s Regional Design add the trimmings—the jelly beans you own) more interested in creating your own layouts, you can use image-editing can easily find it again later. (Note: If layers are who is preparing to design her first scrapbook Annual, the American Advertising Awards, Bookbuilders scanned, or the leaves you downloaded, or the Q What process do you go through when you design • Digital embellishments (digital software like Jasc Paint Shop Pro 8 to create a totally new design. This new to you, see Chapter 3 for more about how page? West Book Show, Independent Publishers Book Awards, buttons that came with the scrapbooking kit a new project? stickers, stamps, buttons, etc.) You-Do-It project shows you the whole digital scrapbooking process— layers work in image-editing programs.) and the American Graphic Design Awards. I wanted to you purchased online, for example. Have fun! And also, pick out the thing that’s A A ask Aren about her love of page design and her insight on from start to finish—using Paint Shop Pro. For me, the process is about preparation. Most of 7. most important and make your other layers Add text. Select the Text tool (fourth tool from 11. Save your page. Choose File > Save and enter a what goes into an effective page design. my work is book cover design, which is not unlike secondary. Throw in something unexpected: follow the bottom in the tools row) and choose the name for the page. If you want to send the page designing scrapbooking pages. You have only a quick sec- all the rules of page layout, but then break one. You Q font, size, style, color, and alignment of the text T P I via email, save a copy (choose Save As) as a ond to catch your reader’s attention. I begin with what- 1. What do you love about page design? Start the program. Launch Paint Shop Pro by might put type at a little angle every now and then. you want. Click on the page where you want to ever’s most important—words or an image—and place it JPEG image. This figure shows the simple page choosing Start > All Programs > Jasc Software > Put a picture you’d expect to see in color in black When you begin using specialty papers and textures add the text (you can move this later) and type on the cover in the size I want. Then I take my hierarchy Page design is a challenge. It takes a lot of prepara- A enhanced with a background image, special and white. Do something that stands out from the Jasc Paint Shop Pro 8. as page backgrounds, you’ll leave the background your journaling text. Click outside the text to of information and add other elements. I tend to design tion of your subject matter to figure out what you effects on the photos, and drop shadows and ordinary. color set to white and open a JPEG file containing 2. deselect it. Create a new file. Open the File menu and around what’s going to get the most attention. think is the most important. I think that’s the biggest chal- lighting effects on the title and subtitle. the background image you want to use. choose New. In the New Image dialog box, enter Aren’s Favorite Scrapbook Page: The collage lenge: to figure out what you really want to show your 8. Add a title. Still using the Text tool, choose Q Where do you get your inspiration? reader and what’s just secondary. is created with memorabilia that my grandfather a Width of 8.5 and a Height of 11. Set the reso- the font, size, style, color, and alignment of had from his service in the Navy in World War 4. lution to 300 dpi. Select your photos. Choose File > Browse and your title text. Click on the page where you Q II. The photos are ones that he had taken in his I keep a cool designs file with layouts I really like. I A How long have you been a designer? 3. double-click an image you want to use. Copy it want the title to go; then enter the title. Choose a back- travels and the portrait in the lower right is actu- also spend a lot of time in the bookstores to see and then choose Edit > Paste As New Layer to ground color. Click ally my grandparents’ wedding portrait. It was a what’s going on in design. I tend to spend a lot of time in I have degrees in design and photography. There A add it to the new document page. Repeat with in the Color box, wonderful piece to work on and very exciting to really obscure sections, maybe at the novel covers. Novels are many similarities between cover design and additional images you want to add. and when the Color listen to my grandpa talk about the places that are so competitive—their cover designs tend to be cut- good photography—you think about how to break up 5. dialog box appears, he had been and all of his sailor friends whom ting-edge. It’s helpful to see how other designers put space and use foreground and background. I was one of Resize and position the images. Click the he could still name by name. I only wish that I’d things on the page and use the space available to them. select the color you those kids who just knew what they were going to do. Deform tool (second from the top in the tools had a tape recorder or had taken notes as he want to use for the Not long ago, I was pulling some old pictures for a school row on the left side of the Paint Shop Pro win- What do you think is the most important element Q told stories. My grandpa has since passed away project and going through art projects my grandmother page background. dow) to resize the images to the size you want; on the page? so this particular piece is very dear to me. had saved… I got first place in the poster contest… I had Try selecting some- then position the mouse pointer on the center drawn an ambulance with the typography all laid out… A In every project, there is always a most important thing that will com- of the image and drag it to the desired position and my type had serifs on it! Both my parents are very element. It might be your photograph—it might be plement the colors Thanks, Aren, for sharing your experience, on the page. artistic and I used to watch my dad hand-letter signs for the text. Or if you have two things that are very close in in the photos you inspiration, and insight with us. want to use. 64 65 90 91 CHAPTER 2 The Big Picture: Plan Your Scrapbook CHAPTER 3 Design Your Pages
    • book design + composition kim scott / kim@bumpy.com / www.bumpy.com photoshop cs2 for Advertising and marketing 2006 Peachpit Press / interior design, template setup, custom composition outdoor ad campaign 4 outdoor ad campaign campaign outdoor ad campaign outdoor ad campaign outdoor ad campaign outdoor ad campaign outdoor Advertising—A MediuM in its oWn rigHt Create a 14´ x 48´ billboard, called a Bulletin, for an outdoor adver- Outdoor advertising is unlike any other advertis- project description ➤ choose colors wisely. Use colors that are tising campaign. This will be the key art for an outdoor campaign ing medium. It can be very effective, delivering appropriate for the genre and that support the launching a new television sitcom, Alpha Male. The campaign will high viewer memory retention and product emotional thrust of the campaign. For easy be concentrated in three major markets—New York, Chicago, and recognition. Or it can be totally ineffective and a viewability, the colors should be strong in Los Angeles. The media buy will include billboards, bus sides, tran- huge waste of money. contrast—both value and hue. Complemen- sit shelters, and shopping mall kiosks. Your design must be equally tary colors (opposites on the color wheel) Here are some pointers that will make your out- effective whether viewed from 50 feet or 3 feet. always work well together, but make sure they door advertising more effective. are of significantly different values so they are Illustrate in a playful way a relationship in which the man thinks he design direction easily differentiated well from a distance. ➤ Keep it simple. For the highest degree of is in charge but is actually being affectionately manipulated by his memory retention, the idea should be clear spouse. Establish audience recognition of the stars and create a ➤ stand out from the crowd. There are cer- and simple. Make use of surprise, humor, or logo that will brand the show. tain things you can do to embellish and draw drama. The ad will have greater memory re- attention to your ad, such as 3D elements, outdoor advertising is an important component “Selects”—photos of the show’s stars that have been approved tention if it entertains and intrigues. assets moving parts, and extending the image be- for use in advertising and promotions—have been provided and yond the borders. Of these, the most common of any national marketing campaign for a television program 4 ➤ make the type easy to read. Type must be include a head shot of the male lead and three of the female lead. is the use of extensions. Breaking the frame of legible at a glance from a distance. Very often A body double was photographed in a playful kick pose. You have a billboard with the top of a head, other body or motion picture. Typical outdoor campaigns include multiple you have only a few seconds to get your mes- been instructed to incorporate this image into the logo in some part, or object immediately creates a more sage across. The type needs to be larger than way if possible. The head of the show’s female star will have to be dynamic ad. Of course, this will add consider- venues and formats. Familiarize yourself with the media buy you might expect or find attractive. Choose composited onto the double’s body. ably to the production costs. fonts that are easy to read. The fonts should and specifications before you begin. Then, create your key be bold, but not too bold—from a distance ➤ Frequency. Although the viewer may be With those assets you will use these tools and techniques: letters set in very heavy type become indistin- see your ad for only a few seconds, repeated art for the largest size. Once it’s approved, you will use that 4 Clone Stamp tool guishable from one another. The fonts should exposure will insure that your message is not be overly designed, overly compressed, 4 Color Correction absorbed and retained. To accomplish this artwork to create all of the other configurations. or overly ornamental. If a serif font is used, most campaigns will include multiple venues 4 Healing Brush it should be one that doesn’t have extreme and formats within a single market. A person 4  Spot Healing Brush changes between the thick and thin portions may be exposed to a couple of billboards, a 4 Mix and match body parts of the letters. Upper- and lowercase words transit shelter, and a mall kiosk all in one day. are considered easier to read. All-uppercase 4 Retouching using a paint layer with a grain overlay To avoid viewer fatigue and memory decline, words can have a strong impact, but should 4 Shape Layers multiple variations on the design or concept be used for only a few words or a very short may be used. Be sure the variations all have 4 Shape tools sentence. the same look and feel. You want the viewer 4 Vector masks to immediately make the connection between the ads. 132 133 Pr o j eCt 4 : outdoor Ad cAMpAign P h oto sh oP C s2 for Advertising And MArketing All images in this project by www.PhotoSpin.com © All rights reserved. create a billboard mini-tutorial 1.2 Mechanical speciFications For outdoor advertising Create a billboard in five stages The Gradient Editor comprises two main sections. Below the Gradient Presets are the parameter con- O At the top are the Gradient Presets, with thumbnails trols where editing takes place. Here you see the utdoor advertising is created at surprisingly low standard Bulletin Gradients of all the currently available gradients. Gradient bar, which displays the current gradient Mask out the backgrounds on each of the main images you 1. resolutions. Artwork is usually built to a scale of Viewing area: 14´h x 48´w and shows how the gradient is constructed. Along will use. either 1⁄8˝, 1⁄4˝, or 1⁄2˝ in the electronic file is equivalent to Mechanical specifications: 1⁄4˝ = 1´ the bar are small controls called stops—opacity one foot in the printed output. The outdoor company Bleed: 3.75˝h x 12.25˝w 2. Create the final document and place these images to get a feel stops along the top, color stops along the bottom— will tell you which scale to use. Unfortunately, it isn’t Live: 3.5˝h x 12˝w for the overall layout. each indicating the point on the gradient where the consistent from format to format or company to com- 3. Create the title logo and network logo using the Type and parameter takes effect. Slide them back and forth pany. Resolution may also vary, depending in part on premiere square Shape tools. Also, with the Type tool, set the headline and tune- along the bar to create different types of gradients. the technology being used to produce the final product. Viewing area: 26´h x 24´w T in information. create a finished-looking piece of art, but to intro- here’s an industry term, “Adding production But the resolution usually cannot be more than 600ppi Mechanical specifications: 1⁄4˝ = 1´ Opacity stop duce you to the capabilities of this remarkable tool value, ”that means making a production appear or less than 300ppi at the scale specified. Obviously, Bleed: 6.75˝h x 6.25˝w Once all the major elements are in place, use Photoshop’s Figure 4-1 4. and get your creative juices flowing. bigger, more impressive, more expensive. As a higher resolution will result in better-looking images. Live: 6.5˝h x 6˝w retouching tools to correct flaws and enhance the appearances designer, your goal is to add maximum production Resolution: 600ppi of the show’s stars. value to your graphics for minimum cost and effort. There’s an inconsistency in the way viewing sizes and tHe grAdient editor 5. In the final step, put the female star’s head on the body of Gradient One of Photoshop’s most effective tools for accom- mechanical sizes are given. It can be quite confusing 30-sheet poster bar the kicking woman and make color corrections so the body plishing this is the Gradient tool. The Gradient Editor is the key to getting the most and could lead to some costly mistakes. Viewing area Viewing area: 10´5˝h x 22´8˝w (5.25˝h x 11.75˝w) matches the head. out of this tool. Let’s take a look at how it works. is always specified with height first then width (un- Mechanical specifications: 1⁄2˝ = 1´ Gradients are gradations or transitions from one Choose the Gradient tool and examine the options like print advertising where width is always first, then Bleed: 5.75˝h x 11.75˝w color or value to another. The gradations can be bar. In the options bar just to the right of the tool MAsk tHe tAlent height). I have never seen these dimensions listed dif- Live: 4.75˝h x 10.75˝w based on various parameters, such as hue (from icon is the Gradient Preview. This displays the ferently. However, mechanical specifications can be Open the image leo.tif. Double-click on background and 1. green through blue to purple, for example), or currently selected gradient. Click on it to open the Three of the gradients, the first two and the last, inconsistent, sometimes listing width first, then height. transit shelter poster (Bus shelter) Midpoint marker Color stop rename it leo. opacity (from more transparent to more opaque), Gradient Editor. are exceptions in that they rely on the current fore- Read specifications carefully, make sure you recon- and mall Kiosk 2. Make a new group named LEO and move the layer leo into the or value (lighter to darker)—or all of these. The way ground and background colors, not predetermined cile the viewing area dimensions and the mechanical (note the H/W inconsistency) Gradient styles group LEO (Figure 4-1). If you skipped Project 2 and are un- these gradations behave is largely determined by colors. Choose the first one to make a gradient that You can add more stops simply by clicking near the dimensions. Don’t hesitate to ask questions when in Viewing area: 5.562˝w x 8.187˝h Figure 4-2 comfortable working with the Pen tool, stop now and do Mini- the Gradient style (Linear, Radial, Angle, Reflected, transitions from the foreground color to the back- bar; to delete a stop, click it and drag it away from doubt. It’s better to look inexperienced at the beginning Mechanical specifications: 1⁄8˝ = 1´ tutorial 2: creating paths with the pen tool in Project 2. Use Diamond) and the tool’s blending mode. ground color, creating a gradient that fills the entire the bar. To change a color, click the appropriate stop than like a complete fool at the end. Bleed: 5.937˝w x 8.562˝h the Pen tool to make a path around Leo. Around the hair be area. Choose the second one to create a gradient and either access the Color Picker by clicking the Live: 5.5˝w x 8.125˝h Gradient preview Tool blend mode sure to get some of the spiky bits, but don’t go nuts. The top of With all of these parameters, the possibilities are vir- that transitions from the foreground color to trans- field next to the word color in the stops panel below The following specifications provide an idea of the vari- Leo’s head is going to extend beyond the top of the billboard. tually limitless. To make life easy, Photoshop starts parent. The last gradient in the default collection of the bar, or by moving your pointer over the bar, at ous common outdoor formats used. The mechanical King-size Bus side poster (Bus King) That portion will be supported by a separate attachment that you off with a number of presets to choose from, presets uses the current foreground color to create which point the pointer becomes the eyedropper specifications are samples only. Unless otherwise speci- Viewing area 30˝h x 144˝w will be cut out in the shape of the hair, so the silhouette of the which you can use as-is or modify; but you can also a striped effect. and you can sample a color from the bar. fied, the resolution for all sizes should be 600ppi for Mechanical specifications: 1⁄8˝ = 1´ hair needs to be relatively simple. When you are satisfied with create and save your own custom gradients. best quality, but may be as low as 300ppi. Always check Bleed: 30.5˝h x 231˝ w the path, make it into a selection, add a 2-pixel feather, then The small diamonds between the stops are mid- with your outdoor company to obtain their specs before Live: 30˝h x 230˝w Gradient tool add a layer mask (Figure 4-2). Save the image as Leo.psd. In this mini-tutorial, you’ll explore some of these point markers, representing the point at which the starting a job. Resolution: 300ppi possibilities. The goal here is not necessarily to two colors on either side of the marker mix in ex- 3. Repeat these steps on the image kristin1.tif. Don’t forget to n actly equal amounts. Use these to modify how the mask out the space between her hand and her cheek. Eliminate Figure 4-3 the small portion of dress showing on her back (Figure 4-3). 134 135 2 3 Pr o jeCt 4: outdoor Ad cAMpAign Pr o j eCt 1 : AniMe illustrAtion PhotoshoP Cs2 for Advertising And MArketing P h oto sh oP C s2 for Advertising And MArketing
    • book design + composition kim scott / kim@bumpy.com / www.bumpy.com pHtLs: basic and Advanced prehospital trauma Life support 2007 Elsevier/MosbyJems / cover + interior design, style and spec creation 4 5 PREHOSPITAL TRAUMA LIFE SUPPORT CHAPTER 00 Chapter Title Goes Here bronchi and then into bronchioles. Bronchioles (very small to the right side of the heart. The blood is pumped to the SCENARIO bronchial tubes) terminate at the alveoli, which are tiny air lungs, where it is again supplied with oxygen and the car- sacs surrounded by capillaries. The alveoli are the site of bon dioxide is eliminated by diffusion. gas exchange where the respiratory and circulatory systems The alveoli must be constantly replenished with a fresh meet. supply of air that contains an adequate amount of oxygen. This replenishment of air, known as ventilation, is essential You are dispatched to a motor vehicle crash. On arrival, you observe that an SUV has struck a tree with the driver’s side for the elimination of carbon dioxide. Ventilation is mea- of the vehicle. The entire driver’s side of the vehicle has sustained substantial damage. The driver of the SUV, a 30-year- surable. The size of each breath, called the tidal volume, old male, is lying in the grass approximately 30 feet (9 meters) from the incident site. Fire department first responders Physiology multiplied by the ventilatory rate for 1 minute equals the have logrolled the patient onto a long backboard and applied a cervical collar. They report that the patient has been minute volume: unresponsive since their arrival. Periorbital ecchymosis (raccoon eyes) is already present. You observe bleeding from With each breath, air is drawn into the lungs. When atmo- both nares and the right ear. Frequent suctioning is required to maintain a patent airway. Ventilations are irregular and Minute volume = spheric air reaches the alveoli, oxygen moves from the al- snoring sounds are audible. The patient’s skin is pale, and cyanosis is present around the lips. Tidal volume  Ventilatory rate per minute veoli, across the alveolar-capillary membrane, and into the What indicators of airway compromise are evident in this patient? What other information, if any, would you seek from red blood cells (RBCs). The circulatory system then delivers witnesses or the first responders? Describe the sequence of actions you would take to manage this patient before and the oxygen-carrying RBCs to the body tissues, where oxygen During normal resting ventilation, about 500 mL of air during transport. ■ is used as fuel for metabolism. is taken into the lungs. As mentioned previously, part of As oxygen is transferred from inside the alveoli to the this volume, 150 mL, remains in the airway system as dead RBCs, carbon dioxide is exchanged in the opposite direc- space and does not participate in gas exchange. If the tidal tion, from the plasma to the alveoli. Carbon dioxide, which volume is 500 mL and the ventilatory rate is 14 breaths/min, is carried in the plasma, not in the RBCs, moves from the then the minute volume can be calculated as follows: A Upper Airway irway management plays a prominent role in the bloodstream, across the alveolar-capillary membrane, and Minute volume = 500 mL  14 breaths/min management of trauma patients. Its importance is rec- into the alveoli, where it is eliminated during exhalation Minute volume = 7000 mL/min, or 7 L/min ognized even more now than in years past. Studies The airway system is an open path that leads atmospheric (Figure 6-5). Upon completion of this exchange, the oxygen- have shown that the failure to maintain oxygenation and air through the nose, mouth, pharynx, trachea, and bronchi ated RBCs and plasma with a low carbon dioxide level re- ventilation causes secondary brain injury which further to the alveoli. With each breath, the average adult takes in turn to the left side of the heart to be pumped to all the cells Therefore, at rest, about 7 liters of air must move in and compounds the primary brain injury produced at the time approximately 500 mL of air. The airway system holds up in the body. out of the lungs each minute to maintain adequate carbon of the initial trauma. Assuring the patency of the airway and to 150 mL of air that never actually reaches the alveoli to Once at the cell, the oxygenated RBCs deliver their oxy- dioxide elimination and oxygenation. If the minute volume maintaining the patient’s oxygenation and supporting venti- participate in the critical gas exchange process. The space in gen, which the cells then use as fuel for aerobic metabolism. falls below normal, the patient has inadequate ventilation, lation, when necessary, are critical steps in minimizing the which this air is held is known as dead space. The air inside Carbon dioxide, a byproduct of aerobic metabolism, is re- a condition called hypoventilation. Hypoventilation leads overall brain injury and improving the likelihood of good this dead space is not available to the body to be used for leased into the blood plasma. Deoxygenated blood returns to a buildup of carbon dioxide in the body. Hypoventilation outcome. oxygenation since it never reaches the alveoli. Cerebral oxygenation and oxygen delivery to other parts The upper airway consists of the nasal cavity and the of the body provided by adequate airway management oral cavity (Figure 6-2). Air entering the nasal cavity is and ventilation remain the most important components of warmed, humidified, and filtered to remove impurities. Be- prehospital patient care. Because techniques and adjunct yond these cavities is the area known as the pharynx, which devices are changing and will continue to change, the runs from the back of the soft palate to the upper end of well-informed prehospital provider must continually keep the esophagus. The pharynx is composed of muscle lined abreast of these changes. with mucous membranes. The pharynx is divided into three The respiratory system serves three primary functions: discrete sections—the nasopharynx (the upper portion), the oropharynx (the middle portion), and the hypopharynx (the 1. The system provides oxygen to the red blood cells, lower or distal end of the pharynx). which carry the oxygen to all the cells in the body. Below the pharynx are the esophagus, which leads to the 2. In aerobic metabolism, the cells use this oxygen as fuel stomach, and the trachea, at which point the lower airway 12 13 PREHOSPITAL TRAUMA LIFE SUPPORT CHAPTER 00 Chapter Title Goes Here to produce energy. begins. Above the trachea is the larynx (Figure 6-3), which 3. The system removes carbon dioxide from the body. contains the vocal cords, and the muscles that make them work, housed in a strong cartilaginous box. Ventilatory Devices TABLE 6-2 Ventilatory Devices and Oxygen resultant brain injury (hypoxic encephalopathy) and even and can deliver an oxygen concentration of 90% to 100%. Lower Airway Anatomy Concentration death. Therefore proper placement must be confirmed. Tech- All trauma patients must receive appropriate ventilatory Some models additionally have a built-in colorimetric car- niques to verify intubation include the use of both clinical support with supplemental oxygen to ensure that hypoxia bon dioxide detector. However, a single provider attempt- The lower airway consists of the trachea, its branches, and Sample Straddle Head assessments and adjunctive devices. Clinical assessments is corrected or averted entirely. In deciding which method ing to ventilate with a BVM may create poor tidal volumes The respiratory system is composed of the upper airway the lungs. On inspiration, air travels through the upper air- include the following: or equipment to use, prehospital care providers should con- secondarily to the inability to create a tight face seal and Device Liter flow Oxygen and the lower airway, including the lungs (Figure 6-1). Each way and into the lower airway before reaching the alveoli, sider the following devices and their respective oxygen con- squeeze the bag adequately. This skill must continuously be procedure (LPM) concentration* part of the system plays an important role in ensuring gas where the actual gas exchange occurs (Figure 6-4). The tra- Direct visualization of the tube passing through the centrations (Table 6-2). practiced to ensure that the technique is effective and that ■ exchange—the process by which oxygen enters the blood- chea divides into the right and left mainstem bronchi. Each WITHOUT SUPPLEMENTAL OXYGEN Organs of the respiratory system: upper respiratory tract and lower respiratory tract. FIGURE 6-1 vocal cords the trauma patient receives adequate ventilatory support. stream and carbon dioxide is removed. of the mainstem bronchi subdivides into several primary (From Herlihy B, Maebius WK: The human body in health and disease, Philadelphia, 2000, WB Saunders.) Pocket Masks Presence of bilateral breath sounds (auscultate laterally Mouth-to-mouth N/A 16% ■ Manually Triggered (Oxygen-Powered) Devices below the axilla) and absence of air sounds over the Regardless of which mask is chosen to support ventila- Mouth-to-mask N/A 16% epigastrium tion of the trauma patient, the ideal mask has a good fit; is Manually triggered devices can deliver oxygen concentra- Visualization of the chest rising and falling during equipped with a one-way valve; is made of a transparent tions of 100%. Because this device does not permit the Bag-valve-mask N/A 21% ■ ventilation material; has a supplemental oxygen port; and is available provider to feel the compliance of the chest during the ven- (BVM) Fogging (water vapor condensation) in the endotracheal in infant, pediatric, and adult sizes. Mouth-to-mask ventila- tilation process, care must be taken not to over inflate the ■ WITH SUPPLEMENTAL OXYGEN tube on expiration tion satisfactorily delivers adequate tidal volumes by ensur- lungs. Maintaining a tight face seal with this device is easy Nasal cannula 1–6 24%–45% ing a tight face seal even when performed by those who do because the trigger mechanism requires only one hand to Unfortunately, none of these techniques individually is not use the skill often. operate. Complications may include gastric distention, over Mouth-to-mask 10 50% 100% reliable for verifying proper tube placement. There- inflation of the lung, barotrauma, and lung rupture. These Bag-Valve-Mask Simple face mask 8–10 40%–60% fore prudent practice involves assessing and documenting devices should not be used in the field except in unusual all of these clinical signs, if possible. On rare occasions, be- The BVM consists of a self-inflating bag and a nonrebreath- circumstances. Sample T 2 hd Style cause of difficult anatomy, visualization of the tube pass- ing device; it can be used with basic (OPA’s & NPA’s) or Positive End Expiratory Pressure (PEEP): PEEP provides BVM without 8–10 40%–60% ing through the vocal cords may not possible. In a moving advanced (ET or NT) airway devices. Most of the BVM de- an elevated level of pressure at the end of expiration, thus reservoir vehicle (ground or aeromedical), engine noise may make vices currently on the market have a volume of 1600 mL keeping the alveolar sacs and small airways open and filled auscultation of breath sounds nearly impossible. Obesity BVM with reservoir 10–15 90%–100% and chronic obstructive pulmonary disease (COPD) may Nonrebreather 10–15 90%–100% interfere with the ability to see chest movement during mask with ventilation. BOX 6-12 Sample Protocol for RSI reservoir As with the clinical assessments, none of these adjuncts is 100% accurate in all patients. In a patient with a perfusing Demand valve Source 90%–100% Pulse oximeters provide measurements of arterial oxyhemo- Pulse oximeters provide measurements of arterial oxyhe- rhythm, end-tidal carbon dioxide monitoring (capnography) Ventilator Source/Blender 21%–100% globin saturation (Spo2) and pulse rate. Spo2 is determined by moglobin saturation (Spo2) and pulse rate. Spo2 is determined serves as the “gold standard” for determining endotracheal measuring the absorption ratio of red and infrared light passed by measuring the absorption ratio of red and infrared light placement. This technique should be used in the prehospi- *Percentages indicated are approximate. through tissue. passed through tissue. tal setting whenever available. Patients in cardiopulmonary arrest do not exhale carbon dioxide, and therefore neither 1. Sample box numbered list, indented. Sample dummy This is box unnumbered list sample style, indented. There colorimetric detectors nor capnography may be useful in pa- text to show the style. is no hanging indent. tients who lack a perfusing cardiac rhythm. BVM device is appropriate. If the receiving facility is rea- A small microprocessor correlates changes in light ab- Pulse oximeters provide measurements of arterial oxyhe- Securing the Endotracheal Tube. Once endotracheal intuba- sonably close, these techniques may be the most prudent sorption caused by the pulsation of blood through vascular moglobin saturation (Spo2) and pulse rate. Spo2 is determined tion has been performed and proper placement verified, the option for airway management when faced with a brief beds to determine arterial saturation and pulse rate. Normal by measuring the absorption ratio of red and infrared light depth of tube insertion at the central incisors (front teeth) transport time. If the closest appropriate facility is more dis- Spo2 is between 93% and 95% at sea level. passed through tissue. should be noted. Next, the endotracheal tube must be se- tant, then one of the following back-up techniques may be cured in place. The most common method used is to tape considered. Column Heading Column Head 2 Box bulleted list, indented shown here. the tube to the patient’s face. Unfortunately, blood and se- ■ Continuous Quality Improvement Ensure that sources and photo detectors are clean, Text for first column here Next is dummy text for cretions often prevent the tape from adhering satisfactorily, ■ dry, and in good repair. column 2, it looks like this. allowing movement and potential dislodging of the endotra- The ambulance service medical director or his or her desig- Avoid sensor placement on grossly edematous sites. More dummy text Dummy text here, yep cheal tube. Several commercially available products exist nate should individually review all out-of-hospital uses of ■ that may serve to adequately secure the endotracheal tube. medications for intubation or invasive airway techniques. A small microprocessor correlates changes in light ab- A small microprocessor correlates changes in light ab- Ideally, if sufficient personnel are present, someone should Specific points should include the following: sorption caused by the pulsation of blood through vascular sorption caused by the pulsation of blood through vascular be assigned the task of manually holding the tube in proper beds to determine arterial saturation and pulse rate. beds to determine arterial saturation and pulse rate. position to ensure that it does not move. Adherence to protocol and procedures ■ Normal Spo2 is between 93% and 95% at sea level. When Proper indications for the use of medications ■ Back-Up Techniques Now here’s dummy text to show box unnumbered list, flush. It Spo2 falls below 90%, severe compromise of oxygen delivery Proper documentation of drug dosage routes and moni- ■ has a hanging indent. to the tissues is most likely present. If endotracheal intubation has been unsuccessful after 3 at- toring of the patient during and after intubation The next paragraph in the list would look like this. tempts, consideration of airway management using the es- Confirmation of tube placement procedures ■ sential skills described previously and ventilating with a Outcome and complications ■
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