Traumacasts

Audio interviews addressing upcoming research and its application to the injured patient, education efforts related to trauma, and novel methods in the management of injury.

We want to hear your thoughts and reflections on the content produced by the Educational Resources Committee (e.g., the EAST Traumacasts and the EAST In the Arena podcast). Send us your feedback.

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Podcasts Currently Available

Care of the Pediatric Trauma Patient - Part 02 - #177

09/04/2024

Join Drs. Aimee LaRiccia and Melissa Ward as they continue their discussion with guests Drs. Howard Pryor and Erica Hodgeman. In this session, they discuss the management of specific injury patterns in children and how it can differ from the adult population.

Supplemental Material: Rauh JL, Neff LP, Forssten MP, Ribeiro MAF Jr, Sarani B, Mohseni S. Contemporary management and outcomes of blunt traumatic American Association for the Surgery of Trauma Organ Injury Scale grades III and IV pancreatic injuries in children: A Trauma Quality Improvement Program analysis. J Trauma Acute Care Surg. 2024 Sep 1;97(3):365-370. doi: 10.1097/TA.0000000000004270. Epub 2024 Jan 29. PMID: 38282245.

Lamoshi, A., Lay, R., Wakeman, D. et al. Validation of the predictive model for operative intervention after blunt abdominal trauma in children with equivocal computed tomography findings: a multi-institutional study. Pediatr Surg Int 40, 39 (2024). https://doi.org/10.1007/s00383-023-05616-6

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Care of the Pediatric Trauma Patient - Part 01 - #176: 08/27/2024; Join Drs. Aimee LaRiccia and Mellissa Ward as they talk with guests Drs. Howard Pryor and Erica Hodgeman. They discuss the care of the pediatric trauma patient and the intricacies of resuscitation, damage control and more for the pediatric patient.; Listen Download

Management of Diverticulitis Across Settings and Specialties - 175: 07/26/2024; Join Drs. Mohammed Bawazeer and Jaswin Sawhney as they talk with guests Drs. Joseph Sakran and Jason Hall. They discuss the acute and elective management of diverticulitis including such topics as antibiotics, the role of laparoscopic lavage, indications for surgery in the acute and elective settings, management of colovesical fistula and the role of acute care surgeons and colorectal surgeons in the management of this disease process.; Listen Download

Critical Care in the Burn Patient - #174: 06/26/2024; Join Dr. Tatiana Cardenas, and Dr. Samantha Tarras as they speak with guests Dr. Taryn Travis and Dr. Mack Drake. They will discuss the physiology of burn shock, the intricacies of burn resuscitation and the challenges of burn care. Topics include markers of resuscitation, use of pressors, inhalation injury, infection, discussions with family and more!; Listen Download

Discussion from Both Sides of the Drape: Intraoperative Resuscitation of the Trauma Patient - #169: 12/28/2023; 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!; Listen Download

ABC vs CAB and what is xABC?: Hemorrhagic Shock - ED vs OR Intubation? - #167: 07/18/2023; 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.; Listen Download

FFP Resuscitation in Burn: Are Your Patients Missing Out On This Benefit? - #162: 12/05/2022; 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; Listen Download

Pelvic Trauma: What Tools are in Your Toolbox? - #159

07/29/2022

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-e103
doi: 10.1097/TA.0000000000003331. PMID: 34238857.

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Selective Aortic Arch Perfusion-The Next Best Thing for Trauma Resuscitation? What is it and when can we implement it?? - #158: 06/23/2022; 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!; Listen Download

Resuscitative Thoracotomy: Who? When? Why? To What End? - #155: 03/21/2022; 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.; Listen Download

Vasopressin in Hemorrhage Resuscitation - #126

12/04/2019

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 Information
Effect of low-dose supplementation of arginine vasopressin on need for blood product transfusions in patients with trauma and hemorrhagic shock

Arginine vasopressin, copeptin, and the development of relative AVP deficiency in hemorrhagic shock

The pathogenesis of vasodilatory shock

Early use of vasopressors after injury: caution before constriction

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EAST Master Class Webinar - Correction of Coagulopathy: Factor-based vs. Plasma - #115

02/22/2019

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.

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PAMPer Trial - #108

08/24/2018

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.

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What is EVTM? A Discussion with Dr. Tal Hörer about Endovascular Trauma and Resuscitation Management - Traumacast #99

04/23/2018

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 2^nd 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

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Ultrasound in Trauma and Critical Care - Supported by ImaCor - Podcast #97

03/15/2018

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.

Resources
Society 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.

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EAST October 2016 Literature Review: Needle Decompression of Tension Pneumothorax - Podcast #75: 02/06/2017; 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!; Listen Download

REBOA: Techniques, Indications, Pitfalls, and Incorporating it in Your Trauma Program - Podcast #64

09/20/2016

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

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A Randomized Trial of TEG versus Conventional Coagulation Tests to Guide Massive Transfusion in Bleeding Trauma Patients: Interview with Dr. Gene Moore - Podcast #62

08/19/2016

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

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Intraoperative Hypotensive Resuscitation - Podcast #61

08/02/2016

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 Referenced
Carrick 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

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Whole Blood Transfusion: Everything Old is New Again - Podcast #60

07/25/2016

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:

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State of Early Goal Directed Therapy - Podcast #56: 05/02/2016; 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.; Listen Download

Damage Control Resuscitation - Podcast #28: 07/01/2013; A discussion of damage control resuscitation - what it is and how to implement it and why. An interview with Michael Rotondo, MD.; Listen Download

Blunt Splenic Injury - Podcast #27: 04/18/2013; A discussion regarding the management of blunt splenic injury with reference to the EAST Practice Management Guideline on this topic.; Listen Download

Screening For Blunt Cerebrovascular Injury - Podcast #12: 01/11/2012; A discussion with Dr. Martin Croce regarding the use of CTA versus angiography to screen for blunt cerebrovascular injury.; Listen Download

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