After a (brief?!) hiatus, we are launching 2022 with a 2-part series with the one and only Dr. Ken Mattox. In this episode, Dr. Mattox shares with us his thoughts on what the modern general surgeon should look like and how we as surgeons differ from our medicine counterparts. Additionally, we review the history of modern trauma resuscitation, the paradigm shifts that have occurred as it pertains to permissive hypotension, as well as the technological advances that have occurred over the last century that have improved care of the critically injured patient. This is an episode not to be missed!
Time Stamps 00:12 Welcome & announcements 04:21 What does the modern "surgeon" look like? 07:48 The interplay between technology & surgery 10:15 Serendipity & Dr. Mattox's early career 11:28 Finessing & integrating clinical practice with research opportunities 13:45 The 2 most impactful advances in trauma care during the last century: the microchip & organized trauma systems 17:00 Dr. Mattox's thoughts on REBOA & intravascular control/treatment techniques 22:32 MAST pants: lessons learned 25:18 Elevate the BP with MAST and fluids? Increase the mortality!! 26:30 Permissive hypotension 27:06 Vasopressors in the ER?! Hypotension is teleological!!
References Bickell WH, Pepe PE, Wyatt CH, Dedo WR, Applebaum DJ, Black CT, Mattox KL. Effect of antishock trousers on the trauma score: a prospective analysis in the urban setting. Ann Emerg Med. 1985 Mar;14(3):218-22. doi: 10.1016/s0196-0644(85)80443-1. PMID: 3977145.
Bickell WH, Wall MJ Jr, Pepe PE, Martin RR, Ginger VF, Allen MK, Mattox KL. Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Engl J Med. 1994 Oct 27;331(17):1105-9. doi: 10.1056/NEJM199410273311701. PMID: 7935634.
Hirshberg A, Hoyt DB, Mattox KL. From "leaky buckets" to vascular injuries: understanding models of uncontrolled hemorrhage. J Am Coll Surg. 2007 Apr;204(4):665-72. doi: 10.1016/j.jamcollsurg.2007.01.005. Epub 2007 Feb 23. PMID: 17382227.
