Traumacast

This Traumacast contains highlights from the recent Chest Wall Injury Summit held March 28-30, 2019.  If you have an interest in chest wall injury or chest wall stabilization surgery you will probably enjoy this episode.    Click here for more information about the Chest Wall Injury Society (CWIS).

Drs. Carrie Valdez and Dave Morris interview our colleague across the pond- Dr. Mansoor Khan! We review management of penetrating injuries to the upper abdomen, how the pancreas is like a crawfish and finish up with some thoughts on when to call for help.

At the 2019 annual meeting of the Society of Critical Care Medicine, the US military Joint Trauma System (JTS) held another session of the increasingly popular "Case Records of the Joint Trauma System". This is a planned series of presentations where an expert panel is presented with interesting and challenging battlefield trauma cases drawn from the Department of Defense Trauma Registry. This registry has captured data on all wounded patients treated at forward military medical treatment facilities during combat and post-combat operations in Iraq and Afghanistan. This program has been spearheaded by Colonel Jennifer Gurney, an Army trauma surgeon and the current Chief of Trauma Systems Development with the JTS. This challenging and entertaining session focused on critical care management issues and was co-moderated by Colonel Gurney and Colonel (ret) Lee Cancio. The expert panel consisted of: LTC Jeremy Pamplin, Lt Col Jeremy Cannon, COL (ret) John Oh, COL Kevin Chung, and COL Jay Johannigman. For any questi

Introducing our first Traumacast guest moderator, Aditi Kapil! Join Drs. Kapil and Valdez as they interview Dr. Laurie Punch, a trauma surgeon who brought the Stop the BleedSM campaign into the highest risk neighborhoods of St. Louis. www.bleedingcontrol.org Stop the BleedSM St. Louis

Join us as Pam Bixby, Drs. Don Jenkins, Joseph Dubose and Eileen Bulger explain NTI, NTRR and CNTR – and how these organizations can take your research to the next level!  The National Trauma Institute (NTI) is a nonprofit, national coordinating center for trauma-related research and a strong advocate for an increased federal investment in trauma research. Projects under NTI’s management have engaged more than 70 investigators across the U.S. and drawn nearly $90 million in federal and state funding since its start in 2006. NTI is the organizing force behind the Coalition for National Trauma Research (CNTR), which includes EAST, AAST, ACS-COT and WTA.  Dr. Donald Jenkins is a founding board member of NTI and Principal Investigator on the National Trauma Research Repository (NTRR) project, a comprehensive web platform for sharing research data among trauma investigators. Dr. Joseph Dubose is the Principal Investigator on the Prospective Observational Vascular Injury Trial (PROOVIT), a study managed by NTI. Dr.

In this special episode of Traumacast, we present the audio portion of our recent EAST Master Class Webinar.  We had a pro con debate of the utility of clotting factor concentrates in resuscitation and reversal of anticoagulation, with Matt Martin and Bellal Joseph arguing in favor of factor concentrates and Macky Neal and Babak Sarani in favor of plasma-based resuscitation. Click here to watch the webinar held on February 13, 2019.  This Traumacast and Webinar was sponsored by a grant from CSL Behring, makers of K-Centra.    

The 32nd  EAST Annual Scientific Assembly took place January 15-19, 2019 in Austin, TX. The assembly boasted a wide array of educational, scientific, career development, and social programs. EAST Traumacast was there to cover it all and bring you highlights, interviews, and summaries from this great meeting. This Traumacast starts out with an interview with EAST President (2018), Dr. Andrew Bernard, then covers the highlights from the entire meeting, and closes with an interview with EAST President (2019), Dr. Elliott Haut. Those interviewed include  Drs. Bernard, Kuckelman, Ghneim, Isola, Ferrada, Callcut, Do, Scantling, and Haut.

Join us for an intimate conversation with Dr. Joe Sakran, EAST Injury Control and Violence Prevention Committee Chair as he updates us on the #ThisIsOurLane movement and Dr. Eileen Burger, Chair of the American College of Surgeons-Committee on Trauma, to preview the importance of the upcoming summit.  Freedom with Responsibility: A Consensus Strategy for Preventing Injury, Death, and Disability from Firearm Violence.  JACS 2018

Is the era of damage control surgery over? Moderators Dr. Dave Morris and Dr. Carrie Valdez talk with Drs. John Harvin and John Holcomb about the role for DCS in the era of hemostatic resuscitation.  Perhaps it is time to shift our paradigm back to definitive surgery as the default plan now that that we are inducing less edema and coagulopathy with huge doses of crystalloid. Articles/Protocols referenced:The effect of damage control laparotomy on major abdominal comlications : A matched analysis. Am J Surg. 2018 Jul;216(1):56-59. doi: 10.1016/j.amjsurg.2017.10.044. Epub 2017 Nov 11. Decreasing the Use of Damage Control Laparotomy in Trauma: A Quality Improvement Project.J Am Coll Surg. 2017 Aug;225(2):200-209. doi: 10.1016/j.jamcollsurg.2017.04.010. Epub 2017 Apr 23. Direct Peritoneal Resuscitation Nursing Protocol

Dr. Ted Pappas, Professor and Chief of the Division of Advanced Oncologic and GI Surgery in the Department of Surgery at Duke Medicine and Vice Dean for Medical Affairs joins us for an overview of surgical emergencies due to peptic ulcer disease. Do you patch perforations and get out? When is an antiulcer procedure necessary? How do you manage the perforated giant duodenal ulcer? Do you leave a drain? Is a postoperative imaging study needed? When do you operate on a patient with a bleeding duodenal ulcer? We go over these questions and more. This is not a Traumacast you want to miss.

Join our panel of trauma surgeons to discuss @ThisIsOurLane, why surgeons are so enraged and what solutions are possible.  @carrievaldezmd @saranimd @scrubbedin #bloodyscrubs #ThisIsOurLane. Supplemental materials:  ACP position statement NRA position statement National Network of Hospital Based Violence Intervention Programs Oct 2017 ACS Bulletin Views and opinions expressed in this Traumacast are those of the individuals and not EAST. 

The Traumacast you've been waiting for! Join your moderators and Dr. Dan Holena as we dive into how to set up research projects and what the stats really mean. Plus Dan explains why you should watch The Blob and what exactly is a statophile?!

Authors Drs. Jason Sperry and Mark Yazer discuss the PAMPer trial — recently published in the New England Journal.  This important study adds randomized prospective evidence to the benefit of using blood products, and specifically plasma in the pre-hospital resuscitation of injured patients.  They discuss the overview of the trial and how it fits into the larger body of research into best resuscitation practices. Correction: In the original recording, Dr. Morris erroneously referred to Dr. Sperry as “assistant professor.”  Dr. Sperry is a full professor of surgery.  Apologies to Dr. Sperry for this mistake.

Acute mesenteric ischemia of all types is still associated with high mortality rates, despite advances in diagnostic modalities and supportive care, largely due to delay to initiate the appropriate therapy. Dr. Michael Sise joins us to discuss this relatively uncommon but challenging problem confronting the acute care surgeon. This is a comprehensive review you don’t want to miss.

So...when's the last time you packed a chest?  Join us as Dr. Jim O'Connor walks us through management of severe thoracic trauma including packing the chest and leaving it open.  Do you have a suggestion for a Traumacast? Submit your idea. 

Drs. Don Jenkins and Michelle Price from the National Trauma Institute introduce the National Trauma Research Repository (NTRR) an exciting new undertaking that aims to combine data from previous and future trauma research sources, such as PROPPR, PROMMTT, the Glue Grant, DOD, etc.  They also discuss how researchers can access these data and contribute their own data to the ever-growing repository.  Got a project idea for a large national database? Check out NTRR to see if this could work for you.  Disclaimer Statement:The National Trauma Research Repository is sponsored by the Department of the Army, Prime award #W81XWH-15.2.0089. The U.S. Army Medical Research Acquisition Activity, 820 Chandler Street, Fort Detrick MD21702-5014 is the awarding and administering acquisition office. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the view of the Department of the Army or the Department of Defense.  

What is it like to travel to a foreign country on a surgical mission?  We take an in depth look at the experiences of the surgeons, nurses, students, mission leaders, and anesthetists.  Join your moderator, Dr. Carrie Valdez, as she interviews members of the ISHI surgical mission team led by EAST member, Dr. Ziad Sifri.   Supplemental material: www.ishiglobal.orgRutgers Global Surgery Fellowship

Can we help reduce the risk of addiction while also improving pain management in the acute setting?  How does a pain management team improve patient care and satisfaction?  Is your practice on the cutting edge of pain management?  Join Drs. Paul Dangerfield, Tom Scott and Babak Sarani with your moderator, Dr. Carrie Valdez, as we explore these questions, and more!

Esophageal perforation is a critical and potentially life-threatening event with considerable morbidity and mortality. The management tends to be controversial and it requires a thoughtful and individualized approach. Dr. J. David Richardson and Dr. Roxie Albrecht join us for an in depth discussion of challenging esophageal injuries including areas of debate such as the management of injuries recognized late, the preferred methods of surgical repair and buttress as well as the role of exclusion and cervical esophagostomy for diversion. ReferenceWestern Trauma Association Critical Decisions in Trauma: Diagnosis and management of esophageal injuries J Trauma Acute Care Surg. 2015 Dec;79(6):1089-95. PMID:26680145

With the recognition of the Opioid Overdose Epidemic, greater scrutiny is being paid to provider prescribing practices.  Trauma patients represent a unique population due to higher rates of substance abuse, multiple sources of acute pain, and the emergency nature of the care provided.  In this episode, Drs. Andrew Bernard and Douglas Oyler join moderators Drs. Dave Morris and Carrie Valdez to discuss strategies for opioid prescribing for trauma patients. Supplemental Materials:Opioid Overdose | Drug Overdose | CDC Injury Center Substance Abuse and Mental Health Services Administration (SAMHSA)SAMHSA - Medications for Opiod Use Disorder - Executive Summary American Society of Addiction Medicine - Treatment of Opioid Use Disorder Resources