Traumacast

In this episode of Traumacast, we interviewed Dr. Jason Smith and Dr. Ben Zarzaur about an exciting new EAST program called: Investigator Support Team Core, or INVEST-C. This program aims to leverage the considerable amount of research resources of the EAST membership in order to provide research mentorship, research design assistance, multicenter collaborations, statistical support, and editorial services for young investigators with promising research ideas and projects. The program will formally kick off in 2017 with a two-day research “Hackathon” where a small group of selected junior researchers will receive intensive mentorship and assistance to fully develop their research plan, study design, and IRB/IACUC proposal, and leave with a complete or near-complete project that is ready to execute. Listen for some great insights into not only this new EAST program, but also on key lessons and tips to succeed in the field of surgical research. Supplemental Materials: EAST Careercast Programs: There are three current EAST Careercast interviews focused on research and publishing. These include interviews with Dr. Ben Zarzaur, Dr. Joe DuBose, and Dr. Gene Moore. Click here for more information.

In this episode of Traumacast, we hosted an EAST roundtable discussion on firearms policy and firearm-related injury prevention. The discussion centered around the recently released EAST literature review and Practice Management Guideline on the efficacy of restrictive licensing and concealed carry laws for preventing firearm-related injuries, as well as the recent efforts of the Committee on Trauma to promote open discussion and consensus buidling to tackle this challenging problem. The panelists included Marie Crandall and Alex Eastman (co-authors of the EAST PMG), Ronny Stewart (Chair, COT), Nicole Stassen (EAST President), and Kevin Schuster (Chair, EAST Manuscript and Literature Review Committee). This interview was recorded live at the 2016 AAST Annual Meeting in Waikaloa, Hawaii. Supplemental Materials:EAST Practice Management Guideline: Prevention of Firearm-Related Injuries with Restrictive Licensing and Concealed Carry Laws  Firearm Injury Prevention: A Consensus Approach to Reducing Preventable Deaths

In this episode we discuss two issues highlighted in the August 2016 EAST Literature review concerning Pediatric Trauma: the meaning and definition of pediatric traumatic coagulopathy and what to do with an injured child with a tender c-spine and negative imaging. Drs. Barbara Gaines, David Mooney, and John Petty joing moderators Dave Morris and Matt Martin for a thought-provoking discussion that will be interesting to anyone who cares for injured children -- even providers who don't normally treat pediatric patients. Supplemental MaterialsAcute traumatic coagulopathy in a critically injured pediatric population: Definition, trend over time, and outcomes. Outcomes of pediatric patients with persistent midline cervical spine tenderness and negative imaging result after trauma.  

Election season is upon us…Drs. Schuster and Stassen (EAST president) face off with Drs. Patel and Skinner!  The experts debate the merits of cervical spine collar clearance based on CT alone in the obtunded patient.   This debate is based on the EAST 2015 PMG (link below).  Audience members called in and pressed our experts for answers to difficult questions.  Who won the debate…click “PLAY” and find out.  Stay tuned for the next Traumacast! Drs. Kevin Pei and Matthew Martin served as moderators for this debate. Supplemental MaterialsEAST PMG - Cervial Spine Collar Clearance in the Obtunded Adult Blunt Trauma Patient

IMPORTANT NOTE: This podcast is a lead-in to an EAST Master Class online webinar on REBOA that will be held on October 6, 2016 at 5pm (Eastern Standard Time). See the link below to register. After that date, the webinar will be available on the EAST website to view In this episode of Traumacast, we interview Dr. Laura Moore and Dr. Elizabeth Benjamin on one of the current “hot topics” in trauma care and resuscitation, resuscitative endovascular balloon occlusion of the aorta (REBOA). These techniques and devices offer a new therapeutic option for the patient with significant non-compressible truncal hemorrhage, and can serve as a resuscitative bridge to provide additional time to get the patient to the operating room or angiography suite. Dr. Moore and Dr. Benjamin share their experience and insights as two early adopters of REBOA at their Level 1 trauma centers. This interview was recorded live at the 2016 AAST Annual Meeting in Waikaloa, Hawaii. Supplemental Materials:Collection of major REBOA studies and abstracts Register for the October 6, 2016 EAST “Master Class” Live Webinar on REBOA with Dr. Laura Moore and Dr. Elizabeth Benjamin

At the 2016 annual meeting of the Military Health System Research Symposium, the US military Joint Trauma System (JTS) held the inaugural session of a new educational program called "Case Records of the Joint Trauma System". This is the first in 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 Lieutenant Colonel Jennifer Gurney, an Army trauma surgeon and the current Chief of Trauma Systems Development with the JTS. This challenging and entertaining session featured an expert panel representing multiple military services and several allied nations, and was co-moderated by Dr. Gurney and Dr. John Holcomb. Panelists:Colonel Ray Fang, US Air ForceColonel (retired) Don Jenkins, US Air ForceMajor Valerie Sams, US Air ForceColonel Matthew Martin, US ArmySurgeon Captain Rory Rickard, Royal NavyLieutenant Colonel Avi Yitzhak, Israeli Defense Forces Supplemental Materials: Joint Trauma System Website For any questions about this program, suggestions for future venues or cases, and to submit any cases or case material, please email Dr. Jen Gurney.

Viscoelastic assays for assessing the coagulation system have been around for decades, but have recently seen a surge in interest and research in the trauma community. Thromboelastography (TEG) and Rotational Thromboelastometry (ROTEM) provide a real-time assessment of multiple aspects and factors involved in clot initiation, development and maturation, and then breakdown or lysis. Many trauma centers have begun incorporating viscoelastic testing in the initial evaluation of injured patients, particularly among those with known or suspected active bleeding. Although TEG/ROTEM have many theoretical advantes compared to standard or conventional coagulation assays, there have been no prospective controlled trials comparing them head to head until now. We interviewed Dr. Gene Moore, the senior author and principal investigator on a recently published prospective randomized trial comparing the utility and associated outcomes of massive transfusions guided by TEG versus those guided by conventional coagulation assays. This is a must-read paper for all trauma providers, and Dr. Moore provides some great additional insights into the study design, results, and interpretation. Supplemental Materials:Goal-directed Hemostatic Resuscitation of Trauma-induced Coagulopathy: A Pragmatic Randomized Clinical Trial Comparing a Viscoelastic Assay to Conventional Coagulation Assays Annals of Surgery: June 2016 - Volume 263 - Issue 6 - p 1051–1059 EAST Online Education Activity  - TEG/ROTEM Testing in Trauma & Transfusion Management

In this episode, we discuss an interesting study which was recently published in the Journal of Trauma and Acute Care Surgery (see link below) with the study’s lead author, Dr. Matthew Carrick, and the senior author, Dr. Kenneth Mattox.  Drs. Carrick and Mattox describe the extension of the hypotensive resuscitation paradigm beyond the trauma bay and into the operating room, as well as some details about how they were able to accomplish this prospective, randomized trial with exception from informed consent.  In characteristic form, Dr. Mattox also challenges the audience to take on more areas of untested dogma — what he calls the “sacred cows” of patient care — and to make an impact in clinical science research. Article ReferencedCarrick MM, Morrison CA, Tapia NM, Leonard J, Suliburk JW, Norman MA, Welsh FJ, Scott BG, Liscum KR, Raty SR, Wall MJ Jr, Mattox KL. Intraoperative hypotensive resuscitation for patients undergoing laparotomy or thoracotomy for trauma: Early termination of a randomized prospective clinical trial. J Trauma Acute Care Surg. 2016 Jun;80(6):886-96.http://www.ncbi.nlm.nih.gov/pubmed/27015578

Whole blood transfusion, once the norm, is once again rising to the forefront of hemorrhage resuscitation science.  In this podcast, Drs. Philip Spinella and Alan Murdock share their expert thoughts and opinions regarding the rationale for whole blood transfusion.  After listening, you just may want to start using whole blood in your hospital. Articles Referenced: Cotton BA, Podbielski J, Camp E, Welch T, del Junco D, Bai Y, Hobbs R, Scroggins J, Hartwell B, Kozar RA, Wade CE, Holcomb JB; Early Whole Blood Investigators. A randomized controlled pilot trial of modified whole blood versus component therapy in severely injured patients requiring large volume transfusions. Ann Surg. 2013 Oct;258(4):527-32; discussion 532-3 Spinella PC, Pidcoke HF, Strandenes G, Hervig T, Fisher A, Jenkins D, Yazer M, Stubbs J, Murdock A, Sailliol A, Ness PM, Cap AP. Whole blood for hemostatic resuscitation of major bleeding. Transfusion. 2016 Apr;56 Suppl 2:S190-202. Blumberg BS, Kuvin SF, Robinson JC, Teitelbaum JM, Contacos PG.  Alterations in Haptoglobin Levels. JAMA. 1963;184(13):1021-1023 Nessen SC, Eastridge BJ, Cronk D, Craig RM, Berséus O, Ellison R, Remick K, Seery J, Shah A, Spinella PC. Fresh whole blood use by forward surgical teams in  Afghanistan is associated with improved survival compared to component therapy without platelets. Transfusion. 2013 Jan;53 Suppl 1:107S-113S. Strandenes G, Berséus O, Cap AP, Hervig T, Reade M, Prat N, Sailliol A, Gonzales R, Simon CD, Ness P, Doughty HA, Spinella PC, Kristoffersen EK. Low titer group O whole blood in emergency  situations. Shock. 2014 May;41 Suppl 1:70-5 Strandenes G, De Pasquale M, Cap AP, Hervig TA, Kristoffersen EK, Hickey M, Cordova C, Berseus O, Eliassen HS, Fisher L, Williams S, Spinella PC. Emergency whole-blood use in the field: a simplified protocol for collection and transfusion. Shock. 2014 May;41 Suppl 1:76-83. http://rdcr.org/wp-content/uploads/2015/06/2013-williams-blood-transfusion-on-cruise-ships.pdfhttp://rdcr.org/wp-content/uploads/2015/06/2013-williams-blood-transfusion-on-cruise-ships.pdf

In this traumacast, Dr. Howard Champion, EAST Founding Member and 1991 EAST President, and surgical simulation expert shares his experience and vision for simulation in surgery training.  Dr. Champion is a seasoned surgical educator, serving as Chief of Trauma at Washington Hospital Center for many years.  In 2001, he founded SimQuest, a leading simulation platform provider.  Dr. Champion not only discusses his views on the utility of simulation in competency based assessment, but also offers encouragement for those interested in a career in simulation-based surgical education.  Drs. Kevin Pei and Matt Martin serve as co-moderators. Supplemental MaterialsMinimizing Surgical Error by Incorporating Objective Assessment into Surgical EducationSimQuest Website

The 29th EAST Annual Scientific Assembly took place January 12-16, 2016 in San Antonio, Texas. The meeting once again had record attendance, and boasted a wide array of educational, scientific, career development, and social programs. And of course - dodgeball! The 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 the 29th EAST President,  Dr. Stan Kurek, then covers the highlights from the entire meeting, and closes with an interview with the 30th EAST President, Dr. Nicole Stassen. Supplemental Materials Summary and downloads from the 29th EAST Annual Scientific Assembly Make your plans now for the 30th EAST Annual Scientific Assembly - January 10-14, 2017 Video highlights and interviews from the 29th EAST Annual Scientific Assembly - See what it is all about!

One of the most well known and attended trauma conferences in the world is the Trauma, Critical Care, and Acute Care Surgery Conference, held annually in Las Vegas. Also known as the “Mattox Meeting”, this conference attracts a large and diverse group of attendees with an interest in trauma and emergency surgical care. For the 49th annual meeting we joined forces with the “Behind the Knife” podcast team to cover the conference and bring you interviews and discussions with the incredible group of expert faculty assembled by Dr. Mattox. We also had the opportunity to sit down and interview the Behind the Knife team about their experience and insights from starting a new surgical podcast that has become one of the top medical podcasts in the country.  Interviewees include: The Behind the Knife team (Scott Steele, Jason Bingham, John McClellan), Kenneth Mattox, Ali Salim, Marty Schreiber, Kenji Inaba, Scott Steele, Mike Sise, and Raul Coimbra. Supplemental MaterialsBehind the Knife: www.behindtheknife.org/Trauma, Critical Care, and Acute Care Surgery Conference: www.trauma-criticalcare.com

In this EAST Traumacast, the state of Early Goal Directed Therapy is discussed with two dynamic speakers, Dr. Donald Yealy who is the lead author on the PROCESS trial , and Dr. Ruby Skinner who is a busy SICU director.  This and two other studies prompted changes in the Surviving Sepsis Campaign Guidelines.  Drs. Yealy and Skinner give insight into how early goal directed therapy has changed since the original studies and how the changes have impacted their patient care.  The discussion is moderated by Dr. Kevin Pei and Dr. Matt Martin.

Social media plays an increasingly important role in all aspects of personal and professional life, and can have profound impacts both positive and negative. Having a solid basic understanding of the mechanics and “rules of the game” is critical to successfully adopting and using social media. EAST as an organization has embraced social media, and for the 2016 Annual Scientific Assembly made a concerted effort to increase the social media presence of the meeting on Twitter. We were able to sit down with the core group of EAST Twitter users, aka the “EAST Twitterati”, and discuss how to get started on social media, practical tips and advice for optimizing the experience, key potential pitfalls to be aware of, and how the use of social media has impacted their personal lives and careers. Interviewees: Elliott Haut, Joe Sakran, Christian Jones, Paula Ferrada, Rob Winfield, Jason Smith, Brad Dennis, Alex Eastman, Jamie Coleman, and Tareq Kheirbek Supplemental Materials:Twitter 101 tip sheet

In this episode, we have a lively discussion about the papers reviewed by Dr. Niels Martin in the February EAST literature review.  We were also very fortunate to have Dr. Bob Martindale, who was one of the lead authors for the 2016 ASPEN/SCCM ICU nutrition guidelines, join us to discuss the key issues of importance to Trauma/ICU providers.  We also discuss the effect of age of stored red blood cells with Dr. Martin Schreiber.  Also joining in this discussion were EAST members Dr. Kevin Schuster and Dr. Andrew Bernard.  The discussion is moderated by Dr. Dave Morris and Dr. Matt Martin. Supplemental Materials2016 ASPEN/SCCM ICU Nutrition Guidelines