Traumacasts

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!

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COVID-19 Part 05 - What Have We Learned - #139

12/29/2020

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.

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COVID-19 Part 04 - Care of the Critically Ill COVID-19 Patient - #134

04/15/2020

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 Resources
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.

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

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Palliative Care in Your ACS Practice - #125

10/21/2019

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

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Contemporary Management of Traumatic Brain Injury - Podcast #100

05/09/2018

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 Materials
The BIG (Brain Injury Guidelines) Project: Defining the Management of Traumatic Brain Injury by Acute Care Surgeons

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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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Case Records of the Joint Trauma System Episode #4 - Part 2: The Experts Go to War - Podcast #93

11/15/2017

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

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Case Records of the Joint Trauma System Episode #4 - Part I: The Experts Go to War - Podcast #92

11/14/2017

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

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Delivering Bad News - Podcast #77

02/28/2017

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 references
Communicating Evidence for Participatory Decision Making - JAMA, May 19, 2004—Vol 291, No. 19
Disclosing Harmful Medical Errors to Patients - n engl j med 356;26 www.nejm.org june 28, 2007

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ECMO: Overview for the Acute Care Surgeon and Current Techniques and Indications - Podcast #76

02/21/2017

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

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Modern Management of ARDS and Hypoxic Respiratory Failure - Podcast #69

11/30/2016

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 Materials
NEJM Article on Proning

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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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EAST February 2016 Literature Review Traumacast - Podcast #54

04/07/2016

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 Materials
2016 ASPEN/SCCM ICU Nutrition Guidelines

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Critical Care Management of Traumatic Brain Injury - Podcast #45

11/17/2015

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 Materials
ACS TQIP - Best Practices in the Management of Traumatic Brain Injury

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Airway Pressure Release Ventilation for Severely Injured Trauma Patients - Podcast #36

06/12/2014

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

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Vasopressin Following Hemorrhagic Shock - Podcast #30

07/31/2013

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

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Deep Hypothermia - Podcast #26

02/20/2013

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

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Adult Concussions - Podcast #22

08/29/2012

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.

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Pediatric Concussions - Podcast #21

08/28/2012

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.

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Beta Blocker Therapy For Traumatic Brain Injury - Podcast #15

01/14/2012

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.

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ICU Management of the TBI Patient - Podcast #11

10/26/2011

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.

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Hypothermia in Trauma - Podcast #8

09/16/2011

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

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Brain Tissue Oxygen Monitoring Following TBI - Podcast #3

09/04/2011

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.

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Hepatic Necrosis Following Angioembolization - Podcast #2

08/24/2011

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

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