Traumacast

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 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