Traumacast

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 CenterSubstance Abuse and Mental Health Services Administration (SAMHSA)SAMHSA - Medications for Opiod Use Disorder - Executive SummaryAmerican Society of Addiction Medicine - Treatment of Opioid Use Disorder Resources

Dr. Deb Stein, Chief of Trauma at the R Adams Cowley Shock Trauma Center, shares her expertise on managing traumatic brain injury (TBI). She discusses the importance of timely interventions for elevated intracranial pressure and nuances in seizure and DVT prophylaxis. Nutrition's critical role in TBI recovery is highlighted, along with the complexities of tracheostomy decisions. Stein emphasizes a patient-centered approach and the need for updated guidelines, while also pointing towards promising future research and innovations in TBI management.

As stated on the website for the Endovascular Trauma and Resuscitation Management (EVTM) Society, “EVTM aims to provide a truly Open Access platform for the dissemination of knowledge and peer-reviewed research in the field of endovascular and hybrid hemorrhage control. Besides this we work to spread this new paradigm within trauma management through workshops, symposia and social media.” This society and their associated journal and international meetings are led by Tal Hörer, MD, PhD and his team in Örebro, Sweden. In this traumacast we discuss the EVTM Society, modern endovascular trauma interventions and concepts, and highlights for the upcoming 2nd Annual EVTM Symposium with Dr. Hörer and co-moderators Matthew Martin and Carrie Valdez.Supplemental MaterialsEVTM websiteInformation and registration for the 2018 EVTM symposium

At the 2018 annual meeting of the Western Trauma Association, the US military Joint Trauma System (JTS) held a an educational session called "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 featured an expert panel representing multiple military services and several allied nations, and was co-moderated by Colonel Gurney and Colonel Matthew Martin. The expert panel consisted of: Dr. Kim Peck, Dr. Warren Dorlac, Dr. Rachael Callcut, and Dr. David Feliciano. This 30-minute session was recorded live from the case panel discussion at the WTA 2018 meeting in Whistler, British Columbia, Canada.Supplemental Materials:Joint Trauma System websiteFor any questions about this program, suggestions for future venues or cases, and to submit any cases or case material, please email Dr. Jen Gurney

Ultrasound (U/S) has been described as the "stethoscope of the 21st century." Guests Charity Evans, MD and Benjie Christie, MD, discuss how they have incorprorated U/S in their management of critical patients -- including evaluation of the pleural space, cardiac ultrasound, and indwelling TEE probes to provide instantaneous feedback on the effectiveness of interventions.  We also discuss credentialing for U/S privileges, curricula for trainees, and the utilization of U/S in the trauma PI process. ResourcesSociety of Critical Care Medicine Ultrasound ResourcesEAST and the EAST Traumacast crew wishes to express our gratitude to ImaCor, makers of the hTEE device, for a generous grant that helped make this episode possible.

The 31st EAST Annual Scientific Assembly took place January 9-13, 2018 in Lake Buena Vista, Florida. The assembly boasted a wide array of educational, scientific, career development, and social programs. 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 31st EAST President,  Dr. Bruce Crookes, then covers the highlights from the entire meeting, and closes with an interview with the 32nd EAST President, Dr. Andrew Bernard. Interviews with Drs. Crookes, Bell, Barron, Kale, Pandit, Landman, Sarani, Dennis, Fang, Bernard.Click here to view videos of select keynote presentations delivered during the 31st EAST Annual Scientific Assembly.

Join us for an in-depth discussion of acute anorectal emergencies Dr. Scott Steele, Professor and Chairman of the Department of Colorectal Surgery at the Cleveland Clinic (and co-moderator of the Behind the Knife podcast). We cover anorectal abscess, anal fissure, hemorrhoidal crises, rectal prolapse, rectal trauma and rectal foreign bodies.  Moderated by Drs. Firas Madbak and Carrie Valdez Supplemental materials:Clinical Practice Guidelines from the American Society of Colon and Rectal Surgeons

An important but under-recognized disease in our communities, intimate partner violence represents a significant threat to the health and well-being of the people we serve.  Guests Catherine Otway, RN, SANE-A, SANE-P and Bellal Joseph, MD discuss the scope of the problem, how it relates to trauma care, and how we as trauma providers can influence those within our care for the better.Resources Mentioned in the TraumacastCDC Resources on Intimate Partner ViolenceStrangulation InstituteDr. Joseph's JAMA Surg 2015 Paper

At the 2017 annual meeting of the Military Health System Research Symposium, the US military Joint Trauma System (JTS) held a session of the newly created educational program called "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 featured an expert panel representing multiple military services and several allied nations, and was co-moderated by Colonel Gurney and Colonel Marty Schreiber. The 2-hour session has been broken into two podcasts - part 1 and part 2. A brief introductory review of the military "echelons of care" system and terminology is provided by Colonel Gurney and Colonel Matthew Martin, and was recorded live from Baghdad, Iraq.Supplemental Materials:Joint Trauma System websiteFor any questions about this program, suggestions for future venues or cases, and to submit any cases or case material, please email Dr. Jen Gurney at: Jennifer.M.Gurney.mil@mail.mil