Join Drs. Liz Dauer, Tatiana Cardenas, Samantha Tarras, Mohammed Bawazeer, and Melissa Warta as they interview speakers from the 37th EAST Annual Scientific Assembly including outgoing EAST President Dr. Jason Smith, in addition to Drs. TJ Schaid, Amanda Witte, Lauren Gallagher, Sneha Bhat, Caleb Butts, Rachel Choron, Julia Coleman, Bishwajit Bhattacharya, George Kasotakis, Susan Kartiko, and Melissa Boltz.  Also hear from Annika Kay PA-C and Colleen Trevino NP. Supplemental Material:  EAST Awards and Scholarship Opportunities

Join Drs. Prerna Ladha, Hassan Mashbari and Lauren Dudas and learn about Global Surgery from Drs. Mike Mallah, Chris Dodgion and the EAST Global Surgery Ad Hoc Task Force.  What does Global Surgery  even mean? How can you get involved, who is out there practicing internationally or can you practice Global Surgery domestically?   Supplemental Material: ♦https://www.mcw.edu/departments/surgery/education/global-surgical-programs♦https://medicine.musc.edu/departments/surgery/global-surgery-program♦https://www.panamtrauma.org/♦Incision (International Student Surgical Network) - https://incisionetwork.org/♦GSSA (Global Surgery Student Alliance) -  https://www.globalsurgerystudents.org/♦American College of Surgeons Resident and Associate Society Global Surgery Workgroup (https://www.facs.org/for-medical-professionals/membership-community/resident-and-associate-society/leadership/) form to self nominate♦AAGS (Association of Academic Global Surgery) - https://www.academicglobalsurgery.org/ - opportunities for faculty, resident and student involvement in committees.

Join Drs. Tatiana Cardenas, Zaffer Qasim and Jacob Edwards as they talk with guests Drs. Marissa Mery and Jeremy Cannon.  They discuss trauma resuscitation through the continuum of the trauma bay to OR with perspectives of emergency medicine, surgery and anesthesia providers.  Topics include permissive hypotension, use of pressors, massive transfusion practices, cell saver usage, additional anesthesia trauma training and more!

Join new moderator Dr. Mohammed Bawazeer and Dr. Lauren Dudas discuss the planning and implementation of a robotic ACS program with Drs. Bruce Crookes and Heather Evans.  They talk about the benefits for both patients and the institution and how it has transformed their practices.  The episodes finishes with a game of surgery truth or dare: Lap, Open or Robotic.

Join Drs. Tatiana Cardenas, Liz Dauer and Zaffer Qasim chat with Drs. Paula Ferrada and Sharven Taghavi about ED vs OR intubation in patients with hemorrhagic shock.  They address  ABC vs CAB, the physiology of intubation of patients in shock and reconsidering the dogma.   Supplemental Material:  Ferrada P, Dissanaike S. Circulation First for the Rapidly Bleeding Trauma Patient-It Is Time to Reconsider the ABCs of Trauma Care. JAMA Surg. 2023 May 17. doi: 10.1001/jamasurg.2022.8436. Epub ahead of print. PMID: 37195675.

Join Dr. Tatiana Cardenas host Drs. Leah Tatebe and Rochelle Dicker to discuss trauma informed care.  Learn about what it is, how it affects patients, curriculum you can soon bring to your institution and why it is so important it will be part of ATLS 11! Supplemental Material:Dicker RA, Thomas A, Bulger EM, Stewart RM, Bonne S, Dechert TA, Smith R, Love-Craighead A, Dreier F, Kotagal M, Kozyckyj T, Michaels H; ISAVE Workgroup; Members of the ISAVE Workgroup. Strategies for Trauma Centers to Address the Root Causes of Violence: Recommendations from the Improving Social Determinants to Attenuate Violence (ISAVE) Workgroup of the American College of Surgeons Committee on Trauma. J Am Coll Surg. 2021 Sep;233(3):471-478.e1. doi: 10.1016/j.jamcollsurg.2021.06.016. Epub 2021 Jul 30. PMID: 34339811.  Sakran JV, Bornstein SS, Dicker R, Rivara FP, Campbell BT, Cunningham RM, Betz M, Hargarten S, Williams A, Horwitz JM, Nehra D, Burstin H, Sheehan K, Dreier FL, James T, Sathya C, Armstrong JH, Rowhani-Rahbar A, Charles S, Goldberg A, Lee LK, Stewart RM, Kerby JD, Turner PL, Bulger EM. Proceedings from the Second Medical Summit on Firearm Injury Prevention, 2022: Creating a Sustainable Healthcare Coalition to Advance a Multidisciplinary Public Health Approach. J Am Coll Surg. 2023 Jun 1;236(6):1242-1260. doi: 10.1097/XCS.0000000000000662. Epub 2023 Mar 6. PMID: 36877809.

Join Dr. Lauren Dudas with guest moderator Dr. Hillary Prince of the EAST Injury Control and Violence Prevention Committee discuss ICVP programs with national leaders.  Listen to Injury prevention coordinators Courtney Edwards, DNP, MPH and Mary R. Lauby as well as Jill Braselton, RN, BSN with ThinkFirst National Injury Prevention Foundation discuss their role in violence and injury prevention, creating community partnerships, advocacy and education.  We discuss the importance of a comprehensive prevention plan, trauma surgeon involvement and navigating all this with sparse financial resources.

Join Drs. Lauren Dudas, Jeremy Levin and Samantha Tarras interview speakers from the 36th EAST Annual Scientific Assembly including outgoing and incoming EAST Presidents Dr. Deborah Stein and Dr. Jason Smith, in addition to Drs. Avi Bhavaraju, Milad Behbahaninia, Maggie Bosley, Anthony Douglas, Irma Fleming, Gabrielle Hatton, Lea Hoefer, Sami Kishawi, Jeremy Levin, William “Aaron” Marshall, Ashley Meagher, Ronnie Mubang, Marshall Wallace and Cox-Templeton Winner Dr. Ashley Williams. Supplemental Material:EAST Awards and Scholarship OpportunitiesLaparoscopic Common Bile Duct Exploration information from Wake Forest Study

Join Drs. Jeremy Levin, Michal Radomski and Lauren Dudas discuss the results of the EAST MCT with PI Rachel Choron.  Hear about management options of duodenal injuries, why they can be so clinically challenging and a bit about spearheading an EAST multicenter trial.  Abstract was presented at the 36th EAST Annual Scientific Assembly.  Look for the publication soon! – “Outcomes Among Trauma Patients with Duodenal Leak Following Primary vs. Complex Repair of Duodenal Injuries: An EAST Multicenter Trial” Supplemental Material: Check out the abstract from the 36th EAST Annual Scientific AssemblyInterested in getting involved in an EAST MCT? - EAST Multicenter Trials - The Eastern Association for the Surgery of Trauma  

Join Drs. Cardenas and Dudas discuss the history, role, potential benefits and implementation of FFP resuscitation as a strategy in burn patients with burn specialists Drs. Robel Beyene, Colonel Jennifer Gurney and Tina Palmieri.  What other options are being studied and what is on the horizon?  Don’t miss this information packed discussion!Supplemental Material: Fellowships - The Eastern Association for the Surgery of Trauma

Join Dr. Lauren Dudas as she interviews some of 2022 EAST award & scholarship cipients: the John M Templeton, Jr., MD Injury Prevention Research Scholarship - Dr. Elinore Kaufman, the EAST MCT Junior Investigator Award – Dr. Asanthi Ratnasekera, the Trauma Research Scholarship – Dr. Stephanie Polites.  Hear their EAST stories, what they are using their award money to work on and insight into being surgical scientists.  Supplemental Material: Scholarships & Awards - The Eastern Association for the Surgery of Trauma

Join Dr. Carrie Valdez as she discusses the EAST MCT on Outcomes after Emergency General Surgery and Trauma Care in Incarcerated Individuals with authors Drs. MK Bryant, Liz Dreesen, Sara Scarlet and Rebecca Maine.  Learn about outcomes, working with your IRB, and what you can do to increase ethical and compassionate care. Supplemental MaterialOutcomes after emergency general surgery and trauma care in incarcerated individuals: An EAST multicenter study. Bryant MK, Tatebe LC, Rajaram S, Udekwu PO, Wurzelmann M, Crandall ML, Zuniga YD, Tran V, Santos A, Krause C, et al. J Trauma Acute Care Surg. 2022 Jul 1;93(1):75-83.

Join Drs. Shyam Murali and Lauren Dudas with guest host Dr. Megan Quintana discuss pelvic hemorrhage control with experts Drs. Tatiana Cardenas and Joe DuBose.  Hear about the different options for hemorrhage control in patients with pelvic fractures so you can maximize patient management at your institution.  They also discuss pitfalls, complications and special populations.  Supplemental Material:DuBose JJ, Burlew CC, Joseph B, Keville M, Harfouche M, Morrison J, Fox CJ, Mooney J, O'Toole R, Slobogean G, Marchand LS, Demetriades D, Werner NL, Benjamin E, Costantini T. Pelvic fracture-related hypotension: A review of contemporary adjuncts for hemorrhage control.Journal of Trauma and Acute Care Surgery: October 2021 - Volume 91 - Issue 4 - p e93-e103doi: 10.1097/TA.0000000000003331. PMID: 34238857.

Join Drs. Brandon Parker, Megan Quintana and Lauren Dudas chat with Jonny Morrison and Jim Manning about SAAP: selective aortic arch perfusion.  What is it, how is it superior to existing resuscitation methods, who would benefit, how close is it to utilization and more!

Join Dr. Nick Namias and Dr. Caroline Park as they discuss the ongoing IV Contrast Shortage with Dr. Lucy Ruangvoravat and Dr. Carrie Valdez. Supplemental Material:  Cavallo J, Pahade J. Practice Management Strategies for Imaging Facilities Facing an Acute Iodinated Contrast Media Shortage. AJR Am J Roentgenol. 2022 May 13. doi: 10.2214/AJR.22.27969

Created in coordination with the EAST Rural Trauma Committee. Drs. Lauren Dudas and Michal Radomski discuss Emergency General Surgery (EGS) with rural providers Dr. Nicholas Bandy, Dr. Kristin Colling & Dr. Keelin Roche.  Listen to hear about rural practice models, procedures important to become comfortable with as rural providers, a bit about organizing an EGS service, and considerations for pursuing a career in rural surgery.

Dr. Jeremy Levin and Dr. Megan Quintana discuss Resuscitative Thoracotomy (RT) with Dr. Ronnie Mubang and Dr. Adam Nelson.  They dive into patient selection, application of ultrasound, different institutions’ criteria, the clamshell, and some less tangible benefits of RT besides survival.  Additionally, hear their opinion about select patient scenarios and special populations.  And ALWAYS wear your PPE! Supplemental material: Joseph B, Khan M, Jehan F, Latifi R, Rhee P. Improving survival after an emergency resuscitative thoracotomy: a 5-year review of the Trauma Quality Improvement Program.Trauma Surg Acute Care Open. 2018 Oct 9;3(1):e000201. doi: 10.1136/tsaco-2018-000201. PMID: 30402559; PMCID: PMC6203136. 

Join hosts Drs. Tatiana Cardenas, Lauren Dudas, Megan Quintana, Samantha Tarras, and Carrie Valdez as they interview speakers from the 35th EAST Annual Scientific Assembly held in Austin, Texas. in Austin, Texas.  Guests: Drs. Laszlo Kiraly, Taylor Wallen, Amanda Hambrecht, Majid Chammas, Jessica Schucht, Abid Khan, Aaron Hudnall, Ander Dorken Gallastegi, Leah Tatebe, Gillian Hoshal, Maxwell Braverman, and EAST President Deborah Stein.

Join hosts Drs. Tatiana Cardenas, Lauren Dudas, Megan Quintana, Samantha Tarras, and Carrie Valdez as they interview speakers from the 35th EAST Annual Scientific Assembly held in Austin, Texas.  Guests: Drs. Jeffrey Claridge, Sharmila Dissanaike, Sneha Bhat, Mary Bryant, Kaushik Mukherjee, Chad Hall, Caroline Ricard, Megan Quintana, Michael Pasquale, James Bardes, Victoria Miles and Youssef Shaban.

Who is hacking our hospital systems and why?  What can you do about it?Listen in as we interview Menny Barzilay, partner at Cytactic – Cyber Crisis Management, and Matan Scharf. Both guests are internationally known cyber security experts, formerly in the intelligence services of the Israeli Defense Forces and currently working at Tel Aviv University. Join Drs. Carrie Valdez and Lauren Dudas for a fascinating discussion on Cybersecurity.   Additional resources and links to more talks with our guests are listed below.  Supplemental Material:Menny Barzilay website, great resources, newsletter and blog - https://www.mennyb.com/blog Cyber attack suspected in German woman’s death, NYT article: https://www.nytimes.com/2020/09/18/world/europe/cyber-attack-germany-ransomeware-death.html Death by Cyber, YouTube talk by Menny Barzilay - https://www.youtube.com/watch?v=N_5Pv9sd40A&ab_channel=GlobalCloudComputingCommunity Autoimmune Deficiency, Hospital Cyber Defense, YouTube talk by Matan Scharf - https://youtu.be/y1r3xuwWnjY Securing the World: Cybersecurity in the Age of IoT, YouTube talk by Matan Scharf - https://youtu.be/SJVVrr-cmF4

Celebrating 10 Years of EAST Traumacast! Dive into conversation as Dr. Michal Radomski and @ldel302 interview @carrievaldezmd Dr. Dave Morris, @docmartin22 @saranimdDrs. Michal Radomski and Lauren Dudas interview previous EAST Traumacast moderators Drs. Carrie Valdez, Dave Morris, Matt Martin and Babak Sarani.  Share laughs with the originators as you hear how it all started and how the program got where it is today!  A special thank you to Christine Eme, EAST Staff, for all of her production support and the many others who dedicated their time over the past 10 years.  Also check out the new introduction, created by EAST member Dr. Shyam Murali.  Here’s to the next decade of EAST Traumacast listening!

Drs. Tatiana Cardenas and Lauren Dudas discuss pilonidal disease with Drs. Patrick McGonagill and Joga Ivatury.  Listen to hear about how to plan your acute intervention without being detrimental to definitive options, different excisional techniques and patient selection.  You’ll hear – pilonidal disease is about so much more than just “rearranging butt cracks!”

Drs. Jeremy Levin, Michal Radomski and Carrie Valdez discuss with Dr. Brad Dennis and Dr. Steven Weisbord contrast associated acute kidney injury – from the renal medulla to “renalism,” a discussion of clinical consequences, and much in between.  Should I adjust imaging order based on existing AKI?  Should risk of AKI alter imaging acquisition decision making in the trauma bay?  Are there strategies to mitigate the impact of contrast?  Listen to find out! Supplemental Material: Guidelines – KDIGO Weisbord SD, Gallagher M, Kaufman J, Cass A, Parikh CR, Chertow GM, Shunk KA, McCullough PA, Fine MJ, Mor MK, Lew RA, Huang GD, Conner TA, Brophy MT, Lee J, Soliva S, Palevsky PM. Prevention of contrast-induced AKI: a review of published trials and the design of the prevention of serious adverse events following angiography (PRESERVE) trial. Clin J Am Soc Nephrol. 2013 Sep;8(9):1618-31. doi: 10.2215/CJN.11161012. Epub 2013 May 9. PMID: 23660180; PMCID: PMC3805082. Inker LA, Eneanya ND, Coresh J, Tighiouart H, Wang D, Sang Y, Crews DC, Doria A, Estrella MM, Froissart M, Grams ME, Greene T, Grubb A, Gudnason V, Gutiérrez OM, Kalil R, Karger AB, Mauer M, Navis G, Nelson RG, Poggio ED, Rodby R, Rossing P, Rule AD, Selvin E, Seegmiller JC, Shlipak MG, Torres VE, Yang W, Ballew SH, Couture SJ, Powe NR, Levey AS; Chronic Kidney Disease Epidemiology Collaboration. New Creatinine- and Cystatin C-Based Equations to Estimate GFR without Race. N Engl J Med. 2021 Sep 23. doi: 10.1056/NEJMoa2102953. Weisbord SD, Gallagher M, Jneid H, Garcia S, Cass A, Thwin SS, Conner TA, Chertow GM, Bhatt DL, Shunk K, Parikh CR, McFalls EO, Brophy M, Ferguson R, Wu H, Androsenko M, Myles J, Kaufman J, Palevsky PM; PRESERVE Trial Group. Outcomes after Angiography with Sodium Bicarbonate and Acetylcysteine. N Engl J Med. 2018 Feb 15;378(7):603-614. doi: 10.1056/NEJMoa1710933.

Drs. Shyam Murali, Rita Brintzenhoff and Lauren Dudas discuss POCUS with Drs. Sarah Murthi and Paula Ferrada.  Why is it so great? What are some tips for challenging image acquisition?  How can I get a program started?  Can my images get validated? And what is on the horizon?  Hear the answers to these questions and more with this animated group! Supplemental Material:Prospective evaluation of surgeons' use of ultrasound in the evaluation of trauma patients by Grace Rozycki et al.Cold Steel: Canadian Journal of Surgery Podcast with Grace RozyckiSurgical Critical Care Program Directors Society Ultrasound CurriculumQuantifying systemic congestion with Point-Of-Care ultrasound: development of the venous excess ultrasound grading system by William Beaubien-Souligny et al. (original VEXUS Scan publication)

In this second installment of a three part series, Drs. Lauren Dudas and Lucy Ruangvoravat interview Drs. Carrie Valdez, JR Taylor and Erich Schafer, surgeons at designated level II-IV trauma centers.  Listen as they discuss their trauma system, schedules and their perspectives as rural trauma surgeons.  If you missed part one in the series, check out Traumacast #140!

Drs. Patrick McGonagill, Lauren Dudas and Carrie Valdez approach the challenge of managing necrotizing pancreatitis in a multidisciplinary discussion with acute care surgeon Dr. Jose Diaz, hepatobiliary and pancreatic surgeon Dr. Clancy Clark and advanced gastroenterologist Dr. Shyam Thakkar.  What are some of the intervention options? How might I approach it at my center? What are the long term complications to look out for?  Hear about it all!

Guest moderator Dr. Brandon Parker joins Dr. Lauren Dudas to discuss strategies to prevent prehospital death – from the Florida program “Survive the Ride” to the Australia prehospital triage algorithm and some physiology in-between!  Guest speakers: Patricia Byers, MD, Kelsey Ensor, MD, Ben Meadley, PhD and Paul Pepe, MD.Supplemental Material: Survive The Ride Essenstial ECG – Gordon Center (miami.edu)

Listen to the first author of the EAST PMG, Dr. Kodadek and pharmacist Jen Beavers discuss alcohol dependence – from identifying at risk patients to a review of treatment options.  Hosted by new guest moderators Drs. Jeremy Levin, Sam Tarras and Patrick McGonagill as well as Lauren Dudas.  Supplemental Information:Kodadek, Lisa M., Jennifer J. Freeman, Devesh Tiwary, Mack Dillon Drake, M. Elizabeth Schroeder, Linda Dultz, Cassandra White, et al. 2020. “Alcohol-Related Trauma Reinjury Prevention with Hospital-Based Screening in Adult Populations: An Eastern Association for the Surgery of Trauma Evidence-Based Systematic Review.” Journal of Trauma and Acute Care Surgery 88 (1): 106–12. https://doi.org/10.1097/TA.0000000000002501. Alvanzo, Anika, Kurt Kleinschmidt, Julie A Kmiec, George Kolodner, Gerald E Marti, William F Murphy, Carlos F Tirado, et al. 2020. “The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management.” http://links.lww.com/JAM/A192. Ammar, Mahmoud A., Abdalla A. Ammar, Jordan Rosen, Hagar S. Kassab, and Robert D. Becher. 2021. “Phenobarbital Monotherapy for the Management of Alcohol Withdrawal Syndrome in Surgical-Trauma Patients.” Annals of Pharmacotherapy 55 (3): 294–302. https://doi.org/10.1177/1060028020949137.

Dr. Simon Fitzgerald, Dr. Lauren Dudas and Dr. Carrie Valdez discuss how things work on “the hill” with Dr. Joseph Sakran.  Hear an overview of how to transform an idea into policy or just how to get more involved.  Additionally, Dr. Sakran briefly reviews his year as a 2019-2020 RWJ Foundation Health Policy Fellow and how he lives his life to fulfill “purpose over position.” Supplemental Information:Robert Wood Johnson Foundation Health Policy Fellows

Join Drs. Simon Fitzgerald, Lauren Dudas and Carrie Valdez as they discuss the Mayo Clinic practice management guideline with Dr. Martin Zielinski and Dr. Henry Schiller.  We review their trauma group’s practice pattern and how their management has continued to progress since their paper was published.  Supplemental Information:Nickerson TP, Zielinski MD, Jenkins DH, Schiller HJ. The Mayo Clinic experience with Morel-Lavallée lesions: establishment of a practice management guideline. J Trauma Acute Care Surg. 2014 Feb;76(2):493-7. doi: 10.1097/TA.0000000000000111. PMID: 24458056.

Drs. Carrie Valdez and Lauren Dudas discuss the details about a geriatric trauma program with Dr. Ben Gayed and Kathy Smith.  What does it entail? What are the benefits? How can you get a program started at your institution?  The content of this podcast reflects the opinions of those involved not the institutions by which they are employed.Supplemental Information:American College of Surgeons – Trauma Quality Improvement Program: Geriatric Trauma Management GuidelineBeers Criteria

Dr. Carrie Valdez hosts Drs. Alexandra Briggs, Avi Bhavaraju  and Ashley Meagher on our first Traumacast in our series on Rural Trauma.  Dr. Briggs is the chair of the Rural Trauma Ad Hoc Task Force for EAST.   For this Traumacast, the group focuses on the Level 1 trauma experience supporting our rural trauma centers- what are we doing well and what can we do better?Rural Trauma Care: Part 2 - Traumacast #147

Welcome guest moderator Dr. Simon Fitzgerald as he and Dr. Carrie Valdez discuss "What have we learned about COVID-19?" with Drs. Matthew Martin, Kari Jerge, Bellal Joseph and Haytham Kaafrani. This episode was recorded as a vaccine was introduced in the shadow of our third national surge of COVID cases. We focus on updates in COVID management, future research and who should get the vaccine. 

Welcome Dr. Lauren Dudas, our next guest moderator, as she interviews Dr. Don Jenkins and Dr. Dan Grabo on whole blood.  Is it better than component transfusion? What would it take to start a program at your institution? What does the future hold for your transplant, ruptured AAA and OB patients?

Welcome back Dr. David Skarupa to the EAST Traumacast. Drs. Carrie Valdez, Aditi Kapil and Lucy Ruangvoravat dig deeper into complex vascular cases. David addresses additional considerations in the ICU and answers questions raised after his last appearance on Traumacast! 

Welcome Dr. David Skarupa to an EAST Traumacast on Vascular Trauma!  Dr. Carrie Valdez, Dr. Red Hoffman, and Dr. Firas Madbak pick Dr. Skarupa's brain on upper and lower extremity trauma, how to find the aorta and IVC - and can you REALLY ligate them?! - and what do we do for anticoagulation or antiplatelet therapy! 

Join moderator Dr. Red Hoffman as she speaks with Drs. Callie Thompson and Lyndsay Deeter as well as veteran burn nurse Leslyn Wiese about the management of the burn patient.  They discuss how to work up the traumatically injured burn patient, things not to miss in electrical injuries, how to best deal with facial burns secondary to smoking on home oxygen and the challenges of dealing with deep second-degree burns.  They also offer some tips and tricks about how to care for burns at your own institution (if you are not at a burn center).   ResourcesUniversity of Washington Burn Educational Videos on YouTube:  https://bit.ly/3bo8KcY 

Join moderators Drs. Carrie Valdez and Red Hoffman as they speak with Drs. Matt Martin, Haj Reddy and Eddie Chao in New York City.  Recorded on April 14, 2020, this episode offers the latest updates on the care of the critically ill COVID patient.   We "round" with our three guests and discuss the management of each organ system.   References and ResourcesEAST COVID-19 Resources and Information is available here: https://www.east.org/education/covid-19-resources-and-information.  This is meant to be a clearinghouse of information and protocols from various societies and institutions throughout the world.   The proning protocol currently in use at NYC Health + Hospitals can be found here - Proning Protocol The burrito technique for proning is also demonstrated at:  https://bit.ly/2K6csM7 

Join Drs. Valdez and Hoffman to discuss Palliative Care in the era of the COVID pandemic.  Dr. Hoffman lends her expertise and provides great resources linked below, including her podcast series on Surgical Palliative Care.   References and ResourcesSurgical Palliative Care podcast hosted by Dr. Red Hoffman - https://thesurgicalpalliativecarepodcast.buzzsprout.com/ National POLST (Physician Orders for Life Sustaining Treatment) - https://polst.org/programs-in-your-state/?pro=1 Vital Talk - https://www.vitaltalk.org/  Center to Advance Palliative Care (CAPC) - https://www.capc.org/

Join moderators Drs. Matt Martin, Carrie Valdez and Red Hoffman as they speak with Drs. Nick Mark, Sheldon Teperman and Alex Guerrero about the management of the critically ill patient during the COVID-19 Pandemic.  Nick shares his experience in Seattle and Sheldon and Alex share what is currently going on in New York City, the current epicenter of the pandemic.  They discuss the management of hypoxemia (including high flow nasal cannula, ventilator strategies and proning- including a discussion of the "burrito" technique), clinical pearls regarding extubation and the role of CPR in these critically ill patients.   Our experts also discuss the importance of establishing communication channels both within your hospital and within your region and the importance of caring for and protecting both ourselves and all those we work with while "leading from the front."  This is a longer episode, but definitely worth a listen, filled with real life clinical pearls that will assist you and your hospital in preparing for and caring for COVID patients. This episode is dedicated to neurosurgeon Dr. James Goodrich, who died on Monday, March 30, 2020 from complications of the Coronavirus.  Resources discussed within this episode: -EAST COVID-19 Resources and Information is available here: https://www.east.org/education/covid-19-resources-and-information.  This is meant to be a clearinghouse of information and protocols from various societies and institutions throughout the world.   -Dr. Nick Mark's OnePager guide to the care of critically ill patients with COVID can be found here: https://www.onepagericu.com/.   -Fair allocation of scarce medical resources in the time of COVID-19 (NEJM March 23, 2020) can be found at:  https://www.nejm.org/doi/pdf/10.1056/NEJMsb2005114?articleTools=true -A framework for rationing ventilators and critical care beds during the COVID-19 pandemic (JAMA March 27, 2020) can be found  at:  https://jamanetwork.com/journals/jama/fullarticle/2763953 -The COVID Ready Communication Playbook by Vital Talk can be found at: https://www.vitaltalk.org/guides/covid-19-communication-skills/ -The proning protocol currently in use at NYC Health + Hospitals can be found here - Proning Protocol -The burrito technique for proning is also demonstrated at:  https://www.youtube.com/watch?v=qx2z26IL6g8&feature=youtu.be -A reminder that "There are no emergencies in a pandemic."

Join Drs. Matt Martin, Carrie Valdez and Red Hoffman as they speak with EAST President Dr. A. Britton Christmas about the management of surgical patients during the COVID-19 pandemic.  They discuss the latest American College of Surgeons guidelines for Emergency General Surgery, safety in the operating room regarding airway management and laparoscopic procedures as well as thoughts on tracheostomies, chest tubes and ED thoracotomies.  Links below for more information!  -EM physician Dr. Yale Tung Chen chronicles his COVID diagnosis and provides daily ultrasound updates on his Twitter account @yaletung -Minimally invasive surgery and the novel coronavirus outbreak: lessons learned in China and Italy.  Epub ahead of print available. https://bit.ly/2UozPX4  -EAST COVID-19 Resources and Information. This is meant to be a clearinghouse of information and protocols from various societies and institutions throughout the world.  https://bit.ly/2QSV5Cj  -Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (published March 2020) is available https://bit.ly/3dB9H2Z  -Department of Defense COVID-19 Practice Management Guidelines -COVID-19 App - Developed by Dr. Kari Jerge - Download the App - http://covid19medapp.com/View webpage - http://apps.appshed.com/1517747/ -Visit the Vital Talk website to help guide you in difficult conversations with your patients regarding COVID-19 https://bit.ly/2JnnNqQ  -CAPC (Center to Advance Palliative Care) is offering a free COVID toolkit, including symptom management tips that will help you with your primary palliative care skills https://bit.ly/2Uqu9w4  -Dr. Nick Mark's OnePager guide to the care of critically ill patients with COVID. Join us early next week for Part 2 of the COVID series- Nick will be one of our guests! https://www.onepagericu.com/

Dr. Melissa Red Hoffman interviews Dr. Anna Newcomb and Dr. Chris Michetti from Inova Fairfax Hospital, current and past presidents of the American Trauma Society, as well as two trauma survivors, John and Richard.  Their stories are inspiring; their work is awesome.  Links below for more information! Trauma Survivors NetworkAmerican Trauma Society

Enjoy our 33rd EAST Annual Scientific Assembly (#EAST2020) Compilation Traumacast! @carrievaldezmd @drmadbak @Aditi_Kapil   Thank you to @TopKniFe_B @MuhammadKhurru1 @LeahTatebe @Bryanacotton1 @docmartin22 for promoting your residents and fellows – great research!   Interviews with @elliotthaut @blackcloudmd @jjcolemanMD @kamil_hanna @smstreit @scottassen @LeahTatebe and more!

In this EAST Traumacast, Drs. Ian Mitchell (@ianmitchellMD), Alexander Gibbons (@AlexGibbonsMD), and Alejandra Casar Berazaluce (@alejandracasar) present highlights from the 2019 Pediatric Trauma Society Annual Meeting (@PediTraumaSoc).  Great stuff on head injury risk calculation, whole blood and viscoelastic assays in pediatric resuscitation, Pediatric Trauma Research, and firearm violence prevention.

Join us as we discuss how percutaneous techniques have changed the contemporary management of hemothorax. How did percutaneous (pigtail) thoracostomy come about? Are conventional large bore tubes safer or better? How do you approach undrained hemothorax? Dr. Peter Rhee and Dr. Narong Kulvatunyou challenge current dogma as they answer all these questions and more in this timely traumacast. Dr. Firas Madbak and Dr. Matt Martin comoderate.

Pressors in trauma resuscitation? Heresy!  Or is it…?  Dr. Carrie Sims discusses her recently published study showing use of low-dose vasopressin in the trauma bay resulted in lower utilization of blood products, with equivalent outcomes.  Dr. Sims also discusses how she was able to get this study through the IRB with exception from informed consent (EFIC), a major hurdle for high-quality trauma research. Supplemental InformationEffect of low-dose supplementation of arginine vasopressin on need for blood product transfusions in patients with trauma and hemorrhagic shockArginine vasopressin, copeptin, and the development of relative AVP deficiency in hemorrhagic shockThe pathogenesis of vasodilatory shockEarly use of vasopressors after injury: caution before constriction

Join guests Dr. Red Hoffman and Dr. Benoit Blondeau as they help dispel myths and drop knowledge about how to incorporate Palliative Care into your ACS practice. Also, check out these great articles by Dr. Hoffman that deal with some of these same issues: https://jamanetwork.com/journals/jama/article-abstract/2737686 and https://www.ncbi.nlm.nih.gov/pubmed/31446920

So you think you know how to handle pediatric solid organ injuries?  In this Traumacast, we hear from Drs. Ian Mitchell, Regan Williams, Judith Hagedorn, and Bindi Naik-Mathuria from the Pediatric Trauma Society (PTS) about updates to practice management guidelines for pediatric solid organ injury. The discussion is geared toward those that might initially manage a pediatric patient but also those "adult” hospitals caring for kids ages 15 and up.  Links mentioned in the podcast:Pediatric Trauma Society Guidelines Liver/Spleen Guideline - J Pediatr Surg. 2000 Feb;35(2):164-7; discussion 167-9EAST Pediatric Blunt Renal Trauma GuidelinePancreas Guideline - J Trauma Acute Care Surg. 2017 Oct;83(4):589-596. doi: 10.1097/TA.0000000000001576.

Join us for an in depth look at life as a military surgeon.  How did they get involved? What motivates them to re-enlist? How do they prepare for combat surgery? Drs. Ben Miller, Pam Choi and Matt Martin (as a guest!) share their experiences.  

In this special EAST Traumacast episode , guest moderators Drs. Dante Yeh, April Mendoza, Rishi Rattan, Rondi Gelbard, and Vanessa Ho bring you some of the interesting science and topics presented at the 2019 Surgical Infection Society Annual Meeting. On behalf of those of us who already used up our travel allowances, thanks to this great crew! Click here for more information about the Sugical Infection Society.

In this EAST Traumacast, Dr. Firas Madbak interviews Dr. Ben Zarzaur and Dr. Alfredo Carbonell about these rare and challenging hernias. Join us for an in-depth discussion covering optimal timing, repair approaches and management priorities.

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 questions about this program, suggestions for future venues or cases, and to submit any cases or case material, please email Dr. Jen Gurney Joint Trauma System Website

Introducing our first Traumacast guest moderator, Aditi Kapil! Join Drs. Kapil and Valdez as they interview Dr. LJ 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. Eileen Bulger is an NTI and CNTR board member and the Principal Investigator on the National Trauma Research Action Plan (NTRAP) project, managed by CNTR. NTRAP is a large-scale effort to establish a national research agenda that spans the continuum of care. The NTRR launched in 2018 and is now accepting clinical trials data. National Trauma Institute CNTR - Coalition for National Trauma ResearchNTRR - National Trauma Registry Repository

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

Join your moderators Dr. Carrie Valdez and Dr. Dave Morris as they interview Dr. Deb Stein, Chief of Trauma and Director of Neurotrauma at the R Adams Cowley Shock Trauma Center.   Dr. Steinreviews current management of TBI patients in a bedside rounds manner.  A great review! Supplemental MaterialsThe BIG (Brain Injury Guidelines) Project: Defining the Management of Traumatic Brain Injury by Acute Care Surgeons

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 Materials EVTM website Information 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 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 

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 Resources EAST 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 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 at: Jennifer.M.Gurney.mil@mail.mil

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 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 at: Jennifer.M.Gurney.mil@mail.mil

Part 3 of 3 Your hosts, Drs. David Morris and Carrie Valdez kept the conversation going with these Traumacasts recorded during the 2017 AAST Annual Meeting featuring clinical leaders in the fields of trauma, critical care and acute care surgery.  There were so many great interviews captured, we split the Traumacast into a three part series. This Traumacast includes interviews with Drs. Coimbra, Arbabi, Benjamin, Bruns, Delano, Jenkins, & Mehta.

Part 2 of 3 Your hosts, Drs. David Morris and Carrie Valdez kept the conversation going with these Traumacasts recorded during the 2017 AAST Annual Meeting featuring clinical leaders in the fields of trauma, critical care and acute care surgery.  There were so many great interviews captured, we split the Traumacast into a three part series. This Traumacast includes interviews with Drs. Eastman, Hall, Hall, Napolitano, Pieracci, and Rotondo. Supplemental MaterialsSTB 2016 Final Parkland Implementation Guide Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society

Part 1 of 3 Your hosts, Drs. David Morris and Carrie Valdez kept the conversation going with these Traumacasts recorded during the 2017 AAST Annual Meeting featuring clinical leaders in the fields of trauma, critical care and acute care surgery.  There were so many great interviews captured, we split the Traumacast into a three part series. Interviews with Drs. Coimbra, Arbabi, Benjamin, Bruns, Delano, Jenkins, & Mehta.

In this episode of the EAST Traumacast, we discuss the paper "Temporary arterial shunts in damage control: Experience and outcomes" with authors Dr. Sarah Matthew and Dr. Mark Seamon, and EAST reviewer Dr. Tareq Kheirbek.  Have you used an arterial shunt lately? The authors discuss this infrequent intervention and complications that may occur.   Supplemental MaterialsTemporary arterial shunts in damage control: Experience and OutcomesJ Trauma Acute Care Surg. 2017 Mar;82(3):512-517. doi: 10.1097/TA.0000000000001334

Robotics in acute care surgery?  "Fire up the robot at 3am?  It's not a pipe dream.  We talk to two acute care surgeons who have incorporated robotics in their daily practice.  Drs. Ruby Skinner and Andrea Pakula have successfully navigated the robotic space and share their tips and tricks on implementation at your institution.  They also share their vision for robotics for acute care surgeons.   Dr. Kevin Pei serves as moderator.

Learn the story behind one of the most successful medical education efforts in history.  In this episode, moderator Dr. Dave Morris speaks with Randy Styner, son of Dr. James Styner, and survivor of the plane crash that started the whole ATLS movement.  Also joining the discussion are Dr. Ronald Craig, one of the co-founders of the ATLS course, and Heather Talbott, Trauma Program Manager at Bryan Health (formerly Lincoln General in Nebraska, where Drs. Styner and Craig practiced).  Hear the story you think you know, told by those that were there when ATLS was born. Read the book: "The Light of the Moon" written by Randy Styner which details the birth of ATLS. 

"Have we changed the PS 50 (probability of survival) for the elderly trauma patient?"  Dr. Robert Barraco quotes one of his mentors, Dr. Carl Valenziano, in this episode about the topic of elderly falls prevention.  Joining Dr. Barraco in this episode is Dr. Marie Crandall, lead author of the EAST EBR "Prevention of fall-related injuries in the elderly."  Traumacast moderators Drs. Kevin Pei and David Morris discuss many aspects of elderly falls prevention and the larger topic of geriatric medicine as it pertains to modern trauma care with Drs. Barraco and Crandall. Resources and Relevant WebsitesEAST EBR - Prevention of fall-related injuries in the elderlyCDC - STEADI (Stop Elderly Accidents, Deaths, & Injury)Stepping OnCochrane - Interventions for preventing falls in older people living in the communityCochrane - Population-based programs for the prevention of fall related injuries in older peopleAmerican Association for the Surgery of Trauma Geriatric Trauma CommitteeAmerican College of Surgeons - Optimal Perioperative Care of the Geriatric PatientAmerican Geriatrics Society

Dr. Bruce Crookes and Dr. Ronald Sing join moderator Dr. Dave Morris in discussing a new device that was developed for “bridging prophylaxis” against pulmonary embolus.  “Bridging prophylaxis” doesn’t sound familiar?  Listen to this episode to learn more.  This podcast was made possible by a generous grant from Bio2 Medical® .

Crossover episode!  Just like the time the Fonz was on Mork and Mindy, this episode brings the moderators of EAST's Traumacast, Dr. Dave Morris and Careercasts, Dr. Brad Dennis (we'll let you decide who is Mork and who is the Fonz) together. The topic is the training programs available for Adavanced Practitioners: the types of programs available, how the terms "residency" and "fellowship" are used, and what to look for in a reputable program. Guests Jon Messing and Aaron Pugh both run successful Advanced Practitioners training fellowships and are actively involved in developing these programs nationally. Both provide interesting insights into this aspect of trauma provider education. Websites referenced:Association of Post Graduate APRN ProgramsAssociation of Physician Assistant ProgramsAmerican Nurses Credentialing CenterNational Nurse Practitioner Residency & Fellowship Training ConsortiumEAST Fellowship Listings/Advanced Practitioners 

Is TEG better than 1:1? Do field tourniquets save lives? Does targeted temperature management in TBI improve outcomes?  Just a few highlights from this year’s Point Counterpoint Conference in Baltimore, MD, hosted by Dr. Scalea.  The EAST Traumacast was there to cover it all. Join us for exciting interviews with Drs. Scalea, Brenner, Davis, Britt, Stein, Haut, Jacobs, Pollak, Hunt, Efron, Henry, Sarani, Murthi and Pigneri.  Will their points change your practice? Supplemental Material:"TEG Cards" - Thank you to Dr. Bryan Cotton for sharing this information with EAST. 

Ever find yourself in the middle of night wondering “What am I going to do with this hernia disaster??”  Join us as we pick the brains of two experts in the field, Drs. Mike Sarr and Shirin Towfigh, as they explore the bailout options and operative considerations.  A bit of thought now may save the night later!  Moderators: Drs. Carrie Valdez and Dave Morris

Join us for an in depth discussion of NSTI with Dr. Eileen Bulger, MD, Professor of Surgery at the University of Washington and Chief of Trauma Surgery for Harborview Medical Center and Dr. Rondi Gelbard, MD, upcoming NSTI PMG Team Leader and Assistant Professor of Surgery at Emory University.   We discuss the timing of debridement, antibiotic management, role for transfer, HBO and so much more!   Moderated by Drs. Carrie Valdez and Dave Morris

At the 2017 annual meeting of the Western Trauma Association, the US military Joint Trauma System (JTS) held the third session of a new 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 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 both civilian and military trauma surgeons, and was co-moderated by Dr. Gurney and Dr. Matt Martin. Panelists: Carlos Brown, MDMitch Cohen, MDJim Davis, MDMatt Eckert, MDJoe Galante, MDOscar Guillamondegui, MDStephanie Savage, MDDeb Stein, MDSupplemental 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.

Global surgery is gaining traction and trauma is a leading cause of mortality in Uganda.  Dr. Kevin Pei had the privilege of teaching an operative trauma and resuscitation course at Makerere University and Mulago Hospital in Kampala Uganda. In this traumacast, Dr. Pei discusses the role of global health surgery with Dr. Jackie, a senior trauma surgeon at the Mulago Hospital. Dr. Jackie discusses challenges and triumphs and how we can facilitate bilateral clinical exchange.

Unfortunately, delivering bad news comes with our job as surgeons, particularly acute care surgeons. Clearly, our ability to effectively communicate with patients and their loved ones is of paramount importance, but are we all well equipped to handle the task?  In this episode, Drs. Nicole Stassen and Charity Evans share their experience and expertise on delivering bad news and end of life discussions.  Drs. Matthew Martin, David Morris, and Kevin Pei serve as moderators.Other referencesCommunicating Evidence for Participatory Decision Making - JAMA, May 19, 2004—Vol 291, No. 19Disclosing Harmful Medical Errors to Patients - n engl j med 356;26 www.nejm.org june 28, 2007

Extracorporeal Membrane Oxygenation (ECMO) is an advanced modality for rescue of patients with hypoxic respiratory failure with or without associated cardiac failure, and failure to respond to conventional therapy and ventilator management. Previously, ECMO was limited to a few select centers and had scant supporting literature in adult patients for most indications. Over the past 5 years there has been an explosion in interest in ECMO and a proliferation of ECMO programs in the U.S., likely as a result of improved techniques and equipment, a large and relatively successful experience with the H1N1 influenza epidemic, and publication of the CESAR randomized trial that supports ECMO use and referral to an ECMO center for refractory respiratory failure. We discussed ECMO with two leaders in the field: Dr. David Zonies and Dr. Jay Menaker, who shared their knowledge and experience in a review format for the Acute Care Surgeon. Supplemental Materials:The Extracorporeal Life Support Organization (ELSO) website Downloadable adult ECMO simulator and other great ECMO resources

In this episode of EAST Traumacast, we discuss the paper "Cadaveric comparison of the optimal site for needle decompression of tension pneumothorax by prehospital care providers" with author Dr. Dan Grabo and EAST reviewer Dr. Travis Polk.  The discussion highlights the changing dogma about needle decompression location -- you just might be convinced to change the way you use this technique! 

This is the second episode in the series of “Case Records of the Joint Trauma System (JTS). Modern battlefield trauma care is characterized by highly complex and multi-system injury patterns, severe injuries, and care delivered in an austere and resource-constrained environment. This results in fertile ground for challenging management decisions, adverse events, suboptimal outcomes, and even preventable deaths. This episode was recorded during a session at the 2017 EAST Annual Scientific Assembly that consisted of a moderated discussion of 3 cases from the conflicts in Iraq and Afghanistan that resulted in a potentially preventable death, or major adverse outcome. The cases were presented in a standard M&M conference format, with open audience discussion throughout regarding key management decisions and options, and suggestions for preventing or minimizing the adverse events. There were 4 cases presented, emphasizing every phase of battlefield care, from pre-hospital thru to medical evacuation back to the United States. Supplemental Materials:Link to full video of the session on the EAST YouTube Channel. 

The mass shooting of schoolchildren and educators at Sandy Hook Elementary school in Newtown, Connecticut shook the nation and forever altered the lives of a tight-knit community. A documentary film that focuses on the aftermath of this event is now being released, and we had the great fortune to hold a screening of this film and a post-screening discussion and Q/A session with the Director, Kim Snyder, and Dr. William Begg, who was the ER physician on duty the day of this tragic event. This special event was arranged through the efforts of Dr. Joe Sakran and immediate EAST Past President Dr. Nicole Stassen. This Traumacast episode is a recording of the post event discussion and question/answer session that was held on January 10, 2017 in conjunction with the 30th EAST Annual Scientific Assembly.  Supplemental Materials:From the film’s website www.newtownfilm.com: “Filmed over the course of nearly three years, the filmmakers use unique access and never before heard testimonies to tell a story of the aftermath of the deadliest mass shooting of schoolchildren in American history on December 14, 2012. Newtown documents a traumatized community fractured by grief and driven toward a sense of purpose. Joining the ranks of a growing club to which no one wants to belong, a cast of characters interconnect to weave an intimate story of community resilience.”

Listen to the audio from our latest live EAST Town Hall Debate on a current “hot topic” in emergency general surgery, the use of laparoscopic lavage as a minimally invasive and non-resectional intervention for patients who require emergency surgery for perforated diverticulitis. Listen to our experts, Christian Jones and Tejal Brahmbhatt on the “Pro” side and Kevin Schuster and Andrew Bernard on the “Con” side, discuss a recently published meta-analysis and then all of the clinical and technique-related issues surrounding this contentious topic. Moderated by Dave Morris and Matt Martin. Supplemental Materials:EAST November Literature Review - including discussion of the meta-analysis:Angenete E et al. Laparoscopic lavage is superior to colon resection for perforated purulent diverticulitis—a meta­analysis. Int J Colorectal Dis. 2016;(ePub ahead of print)

Drs. Marie Crandall and Christian Jones join moderators Dave Morris and Matt Martin to discuss what may become a landmark paper in emergency general surgery.  Imagine if general surgery diseases could be graded by severity like traumatic injuries are with AIS/ISS.  Dr. Crandall and her co-authors have published just such a severity scoring system, which holds the promise of standardizing our nomenclature across the ACS community.  Listen as Drs. Crandall and Jones discuss the utility of this system and ways to promote its adoption. Article AbstractEAST November 2016 Literature Review

Drs. James Byrne and Amy Makley join moderator Dr. Dave Morris to discuss a very compelling recent paper that looked at the safety of early DVT chemoprophylaxis (within 72 hours of injury) to late (> 72 hrs after injury).  Dr.s Byrne and Makley also discuss the protocols they use in their institutions for this difficult clinical problem and the relative lack of guidelines available to help guide trauma clinicians.  Article Abstract EAST PMG: Evaluation and Management of Mild Traumatic Brain Injury 

In this episode, Drs. Carlos Brown and Lewis Kaplan discuss modern management of ARDS and hypoxic respiratory failure.  Both experts share practical and useful insight and raise important questions and controversies.  You won’t be disappointed!  Drs. Kevin Pei, Matt Martin, and Dave Morris served as moderators.                                                                                 Supplemental MaterialsNEJM Article on Proning                 

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

In this podcast we discuss the process of professional peer review, and how this process can be used or mis-used for a variety of reasons. Our guest is Dr. Larry Huntoon, who has become a recognized national expert in the area of “sham peer review”, and who was written and lectured extensively about common themes in techniques and tactics that are used in these proceedings. He gives some great advice about recognizing, reacting to, and even preventing this type of adverse professional action for surgeons. This interview was done as a “Town Hall” session, and Dr. Huntoon takes questions from the attendees after the formal moderated interview. The discussion is moderated by Dr. Matthew Martin and Dr. Andrew Bernard.  Supplemental Materials:  Editorial: Tactics Characteristic of Sham Peer Review by Larry Huntoon, MD, PhD  Recognizing the Tactics of Sham Peer Review: a 3-part video series presented by Dr. Larry Huntoon

In this podcast we discuss small bowel obstruction – a common problem that can be challenging to treat appropriately – with Dr. Martin Zielinski, Associate Professor of Surgery at Mayo Clinic in Rochester, MN.  Dr. Zielinski  discusses several aspects of small bowel obstruction: which patients need an operation?  Which will resolve with time?  How long should nonoperative management be attempted before taking a patient to surgery?  We also discuss how to utilize the Gastrografin® challenge into the clinical decision making process. The discussion is moderated by Dr. David Morris and Dr. Levi Procter. Supplemental Materials:CT image showing small bowel feces sign and article references

This podcast is from the second EAST Town Hall Debate session, where two panels of experts discuss and compare the Hartford Consensus Conference guidelines and the Emergency Tactical Casualty Care recommendations and program for improving outcomes from active shooter and other intentional mass casualty events. The debate is moderated by Dr. Andrew Bernard. Pro Hartford Consensus ConferenceAlexander Eastman, MDEric Campion, MD Pro Tactical Emergency Casualty CareBabak Sarani, MDE. Reed Smith, MDGene Reilly, MD Supplemental Materials ACS Bulletin with the Hartford Consensus III Report TECC 2015 updated guidelines TECC website

This podcast is the recording of the first inaugural EAST Town Hall Debate session, on the topic of treating patients with an “Antibiotics-only” approach for acute appendicitis versus the standard treatment of surgical appendectomy. This has become a particularly controversial topic recently following publication of the APPAC Trial in JAMA (link to article below). The program started with two teams in a standard debate format, followed by additional expert commentary from two invited guest speakers: Dr. Edward Livingston, Deputy Editor of JAMA and Dr. Elliott Haut, author of an invited commentary on the APPAC Trial. The debate was then opened up to questions and comments from any listener during the live session. The Foes:  EAST Emergency General Surgery Section (Pro Appendectomy) vs. EAST Online Education Section (Pro Antibiotics-only) Moderated by Dr. Levi Procter Supplemental Materials:APPAC Trial - JAMA website. This page also contains links to multiple related commentaries, as well as a podcast interview with the study authors by Dr. Livingston.  

Highlights from the 2015 Western Trauma Association Meeting - Podcast #49 - EP This is the first in our series of podcasts from some of the key trauma and ACS annual meetings. The 2015 Western Trauma Association was held in Telluride, Colorado, and we were there to record the highlights and interviews with many of the attendees and presenters. See below for a listing of the interviews and supplemental materials including a copy of the meeting program book. Next, we look forward to a Traumacast from the 2016 EAST Annual Meeting in San Antonio, Texas. 2:15             Hasan Alam on VPA + fluid resuscitation in a TBI model7:15             Drs. Chapman and Moore on the TEG “Death Diamond” and plasma-first resuscitation14:17           Dr. Nelson on “Sugar or Salt”: relative role of mineralocorticoids in shock17:50           Dr. Olson on a randomized trial of heparin vs lovenox for VTE prophylaxis21:58           Dr. Miller on repairing flank hernias using bone-anchor fixation27:38           Tourniquet Debate: Carlos Brown vs Kenji Inaba32:15            Dr. Berndtson on Outcomes with K-Centra 4-factor PCC36:15            Dr. Russo on pigtail catheter versus chest tube for hemothorax drainage40:25            Dr. Bensard on the utility of routine serum HgB checks in pediatric trauma46:28            Dr. Aydelotte on the impact of marijuana legalization on traffic fatalities51:45            Dr. Parker on the impact of TXA on fibrinolysis parameters by TEG56:25            Dr. Moren on recursive partitioning to better define massive transfusion1:01:55         Dr. Pharoan on massive abdominal wall injury due to fireworks1:06:40         Expert Case Panel: Drs. Shackford, Karmy-Jones, Rhee, & Schreiber1:09:30         Dr. Cohen on the WTA Multicenter study of the “found down” patient1:14:30         Dr. Christine Cocanour on the WTA and her term as WTA President Supplemental Materials: WTA 2015 Program BookDec 2015 issue of the Journal of Trauma and ACS

Pediatric abusive injuries and non-accidental trauma (NAT) are unfortunately common and widespread, and can frequently go unrecognized with disastrous outcomes. In this podcast we discuss pediatric NAT with Dr. Tony Escobar and Dr. Elizabeth Pohlson from Mary Bridge Children’s Hospital. Dr. Escobar and Dr. Pohlson are recognized local and national experts on this topic, and have implemented a hugely successful evidence-based and multi-disciplinary screening and evaluation process at their center. In this podcast they discuss the problem of pediatric NAT, as well as the common “red flags” from the history, physical examination, and radiologic studies that should alert a physician to the possibility of NAT. In addition, they discuss some actual cases and real-world scenarios involving pediatric NAT, along with practical advice for the front line medical provider on optimal evaluation and management strategies. A copy of their standardized NAT evaluation note as well as their evidence based evaluation algorithm are included below in the supplementary materials section.  Supplemental Materials: NAT Evaluation NoteNAT AlgorithmNon-Accidental Trauma slideset

Management of the patient with large or complicated abdominal wall defects requires a broad and deep understanding of anatomy, physiology, and surgical techniques that go well beyond the standard ventral hernia repair. Today we spoke with two experts in the modern management of the complex or multiply recurrent hernia, Dr. Robert Martindale and Dr. Sean Orenstein. We discussed the scope of the problem, the workup of these patients, optimal techniques including the retrorectus repair and the posterior component separation (or “TAR”), and then key postop management issues. This podcast also served as a lead-in to our inaugural “EAST Master Classes” live webinar held on December 7, 2015 . This webinar featured Dr. Martindale and Dr. Orenstein, and they demonstrated several of these repair techniques and strategies. If you missed the live webinar, the session was recorded and placed on the EAST Online Education Center as an enduring talk.

Medical malpractice claims and other litigation have unfortunately become a common occurrence in all fields of surgery. Although each case has unique and specific aspects, there are common patterns, themes, and risk factors that all practicing physicians should be aware of in order to minimize or even completely avoid these situations. In addition, there is a great deal of misunderstanding about how published guidelines such as the EAST Practice Managemenet Guidelines may be used for or against the physician in establishing the standard of care and any violoations of that standard. We discuss these issues with Dr. Carlo Reyes, a board certified Emergency Medicine physician, health care attorney, and nationally recognized expert in medical malpractice, and Dr. Chet Morrison, a Trauma and Surgical Critical Care attending with  a longstanding interest in this area. Supplemental Materials:Legal implications of Pay for Performance article by Dr. ReyesMinimizing your malpractice risk article by Dr. ReyesValue of CPGs as “Safe Harbors” for Legal Defense

In this Traumacast, Drs. Levi Procter and Andrew Bernard interview Dr. Joshua Levine, Chief of Neurocritical Care and the University of Pennsylvania regarding the critical care management of traumatic brain injury.  Dr. Levine is a nationally recognized expert in Neurocritical care. Recently, the ACS COT updated their guidelines on the management of severe traumatic brain injury. We discuss the new-tiered therapies, the pros and cons and how to apply this in your practice.  Supplementary MaterialsACS TQIP - Best Practices in the Management of Traumatic Brain Injury

Rib fracture plating has gained popularity in recent years as more and more Trauma providers have adopted this procedure into their treatment armamentarium.  In this episode of Traumacast Dave Morris and Matt Martin discuss rib fracture plating with Dr. Bill Long, who has extensive experience in treating injuries of the chest wall and was instrumental in the development of one of the commercially available rib plating systems, and Dr. Babak Sarani who has adopted the procedure within the last 5 years.  The topics of discussion include the rationale for performing the procedure, how to select patients who will benefit, and some technique tips. Supplementary MaterialsEAST Online Education Center - Surgical Treatment of Rib Plating by Dr. David Ciesla

An interview with Dr. Alexander Eastman, the Trauma Medical Director at Parkland Memorial Hospital and a current law enforcement officer with the Dallas Police Department, and Dr. Imad Haque, an active duty Army surgeon and the Director of Simulation Training at Madigan Army Medical Center. These two nationally recognized experts discuss what to expect in active shooter scenarios, how to respond, and most importantly how to prepare yourself and your facility through the use of realistic and well-planned simulation training. The interview concludes with a discussion of the rationale and recommendations from the Hartford Consensus Conferences. Supplementary Materials:Active shooter slide presentation from Dr. EastmanDHS Active Shooter Pocket CardHartford Consensus Conference 1Hartford Consensus Conference 2

An interview with Dr. Matthew Martin, the Trauma Medical Director at Madigan Army Medical Center and one of their core faculty on the Bariatric Surgery Service. Dr. Martin is an active member of the American Society for Metabolic and Bariatric Surgery, and serves as an Associate Editor with Surgery for Obesity and Related Diseases. This session is moderated by Dr. Levi Procter, and special guest moderator Dr. Andrew Bernard, who discuss the increasingly common issue of urgent and emergent complications among patients who have had a prior bariatric surgical procedure. The interview covers the initial evaluation and diagnostic workup, operative and nonoperative management strategies, and clinical "pearls" for the acute care surgeon who is faced with one of these challenging scenarios. Supplementary MaterialsBariatric surgery problems and complications syllabusASMBS Poster: Pearls for Emergency Care of the Bariatric Surgery Patient

An interview with Dr. Ernest "Gene" Moore, a giant in the field of trauma and former Editor in Chief of the Journal of Trauma and Acute Care Surgery. Dr. Moore takes us behind the scenes of a major academic journal, and provides advice and insights on starting an academic career and producing high quality and publishable research. He then discusses how to become more active with scientific journals by serving as a peer-reviewer and what it takes to join the Editorial Board. The interview concludes with Dr. Moore's thoughts and experience on the relatively unique career path of becoming the Editor in Chief of a major journal. Supplementary materialsView the online CME activity "So You Want to Publish in the Journal of Trauma and Acute Care Surgery (JOT)? Tips and Tricks for Academic Success in Trauma and Acute Care Surgery" given by Dr. Juan Duchesne. This interview is a combined effort between EAST's Online Education Section and Career Development Section. The interview has been posted on the EAST Traumacast and Careercast pages.

An interview with Dr. Donald Jenkins, one of the leading figures behind the National Trauma Institute (NTI) and the newly created Coalition for National Trauma Research (CNTR). Dr. Jenkins discusses the history, formation, mission, and future of these two organizations and how they are positively impacting the ability to perform high-quality clinical trauma research and fostering a national trauma research agenda.Supplementary MaterialsThe National Trauma Institute information brochureCoalition for National Trauma Research Website"The Trauma Research Imperative" from the NTI

An interview with Dr. Richard Falcone and Dr. Denis Bensard about an exciting new program they have developed to enhance pediatric trauma care in the U.S. They discuss how their Level 1 Pediatric Trauma Center has partnered with multiple adult Level 2 centers to enhance their ability to provide high quality pediatric trauma care, and to successfully obtain ACS verification as pediatric trauma centers. Supplementary materials: download a presentation with additional information and resources related to the PTTC. Link to Dr. Falcone’s CME talk on Trauma Simulation Training

Listen to us discuss the surgical management of clostridium difficile colitis with Dr. Paula Ferrada. We tackle surgical and medical therapy based on the best available evidence. See EAST's Online Education session on this topic too.

Listen to Dr. Matthew Martin discuss the great advances in civilian trauma care as a result of 10 years of conflict.  He tackles great topics such as tourniquets, hemostatic dressings, tension pneumothorax and what's ahead. See EAST's Online Education session on this topic too.

A discussion with Dr. Adrian Maung on the Airway Pressure Release Ventilation (APRV) mode for respiratory failure in multi-trauma patients.

A discussion with Dr. Jason Smith on the utilization of direct peritoneal resuscitation in the treatment of abdominal catastrophes.

A discussion with Dr. Richard Frazee, in regards to a successful protocol for outpatient laparoscopic appendectomy in acute appenditics.

A discussion with Dr. Rob Winfield regarding the effects of obesity in the care of the traumatically injured. 

A discussion about the future of EAST with EAST Past President, Dr. Sagraves. 

A discussion with Dr. Khashayar Vaziri regarding repair of complex abdominal wall hernia, use of mesh, and placement techniques.

A discussion with Dr. Carrie Sims regarding her research into vasopressin deficiency following hemorrhage and its potential role in resuscitation.

A brief discussion of political and financial issues faced when The Trauma Center at Penn opened in 1988. Many of the same issues are still faced by trauma directors in new trauma centers. 

A discussion of damage control resuscitation - what it is and how to implement it and why. An interview with Michael Rotondo,  MD.

A discussion regarding the management of blunt splenic injury with reference to the EAST Practice Management Guideline on this topic.

Emergency Preservation and Resuscitation Trial evaluating deep hypothermia for cardiac arrest following penetrating trauma. Discussion with Dr Sam Tisherman, the PI for the study. 

A discussion with Dr. Eileen Bulger regarding her two trials evaluating the role of hypertonic saline in the pre-hospital setting.

A discussion regarding causes of coagulopathy in trauma and the use of TEG in its diagnosis and management.

A discussion regarding Dr. Haider's study which showed the transportation by helicopter following trauma improves survival.

A discussion with Dr. Robert Barraco regarding the diagnosis and treatment of concussion in adults. This podcast is eligible for AMA PRA Category 1 Credit TM self-assessment credits toward Part 2 of the ABS MOC Program. Visit the EAST Education Center for details.

A discussion with Dr. Michael Nance on diagnosis and treatment of concussion in children, including a proposal for determining when kids can return to contact sports.  This Traumacast is eligible for AMA PRA Category 1 Credit TM self-assessment credits toward Part 2 of the ABS MOC Program. Visit the EAST Education Center for details.

A discussion with Dr. Elliott Haut regarding the pros and cons of screening for DVT in asymptomatic patients following trauma.

A discussion with Dr. Martin Schreiber on the various types of topical hemostatic agents that can be used either pre- or intra-operatively - their mechanisms of action, uses, and limitations. This Traumacast is eligible for AMA PRA Category 1 Credit TM self-assessment credits toward Part 2 of the ABS MOC Program. Visit the EAST Education Center for details.

A discussion comparing the ATLS, ASSET, and ATOM courses and the future role of simulation in trauma surgery training

A discussion with Dr. Adil Haider regarding reasons for increased mortality noted in hospitals that treat mostly minority patients following injury.

Discussion with Dr. Joe Sakran on getting into a trauma fellowship and securing a job

A discussion of the role of beta-blocker therapy following TBI. We discuss Dr. Cotton and others' studies suggesting a mortality benefit, possible mechanisms underlying this finding, and how/when to go about instituting beta-blockade in this population. 

Dr. Champion helped establish EAST and describe the ISS/AIS and TRISS scoring systems. We discussion of various commonly used trauma scoring systems and their shortcomings. We also discuss how to go about assessing and creating a scoring system.

A discussion with Dr. Fred Luchette regarding factors associated with mortality following rib fractures. We discuss who requires evaluation at a trauma center, how requires ICU admission, pain control, and the role of rib plate fixation and tracheostomy in these patients. 

A discussion with Dr. Martin Croce regarding the use of CTA versus angiography to screen for blunt cerebrovascular injury.

A discussion of techniques to minimize secondary brain injury, including measurement of cerebral pressures and oxygen tension and interventions such as the role of steroids, transfusion, hypothermia for brain injury. 

A discussion of measuring and comparing outcomes between trauma centers. Discussion involves use of this information by trauma directors and verifying bodies. 

A discussion with Dr. Bill Schwab regarding the evolution of damage control surgery in trauma care

The current role of hypothermia in trauma care and future directions for use of this modality in the care of the injured patient

A discussion regarding the evidentiary basis for trauma exsanguination protocols in trauma systems and how to go about writing and implementing them

A discussion of the current status of the acute care surgery training program, why it is needed, and how to attract future surgeons to this field. Dr. Britt also discusses some the skill sets that the ACS surgeon will need/have, board certification for this field, and integration of this new subspecialty into the surgical community. 

An in-depth discussion regarding use of TEG to diagnose both hypo- and hyper-coagulable states following injury

A discussion of the CONTROL trial, it's design, findings, and ramifications regarding the role of Factor VIIa in trauma patients. 

An interview with Dr. Peter LeRoux regarding brain tissue oxygen monitoring and the BOOST II trial, a randomized prospective multicenter trial evaluating the feasibility of this technology for TBI.

Interview with Dr. Tom Scalea regarding the treatment of hepatic necrosis following angioembolization for severe injury

An interview with Dr. Michael Rhodes regarding implementing and enforcing clinical practice guidelines in a trauma center