Traumacast

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ECMO: Overview for the Acute Care Surgeon and Current Techniques and Indications Feb 21, 2017

Show notes

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) websiteDownloadable adult ECMO simulator and other great ECMO resources

EAST October 2016 Literature Review: Needle Decompression of Tension Pneumothorax Feb 06, 2017

Show notes

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!

Case Records of the Joint Trauma System Episode #2: A Battlefield Mortality and Morbidity Conference Jan 23, 2017

Show notes

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.

Newtown: What Remains After All is Lost. Discussion and Q/A with Kim Snyder (Director/Producer) and Dr. William Begg (Featured Physician) Jan 19, 2017

Show notes

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.”

EAST Town Hall Debate: Laparascopic Lavage for Perforated Diverticulitis - Useful Tool or Full of Stool? Jan 06, 2017

Show notes

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)

EAST November 2016 Literature Review Traumacast: AAST Severity Scoring for ACS Diseases Jan 03, 2017

Show notes

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

EAST October 2016 Literature Review - When is it Safe to Give TBI Patients DVT Chemoprophylaxis? Dec 22, 2016

Show notes

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 AbstractEAST PMG: Evaluation and Management of Mild Traumatic Brain Injury

Modern Management of ARDS and Hypoxic Respiratory Failure Nov 30, 2016

Show notes

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

Research Support and Mentorship through EAST: The New INVEST-C Program Nov 28, 2016

Show notes

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.

Firearms Policy and Injury Prevention: EAST Roundtable Discussion on EBR Review Nov 14, 2016

Show notes

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

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