Journal of Trauma and Acute Care Surgery - Trauma Loupes Podcast

Journal of Trauma Guest Editors Dr. Todd Rasmussen and Dr. Jeremy Cannon discuss insightful and compelling articles that will appear in the August Military Supplement that will accompany the regular journal August issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, Dr. Gene Moore, discusses the February 2020 issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, Dr. Gene Moore, discusses the May 2020 issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, Dr. Gene Moore, discusses the March 2020 issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, Dr. Gene Moore, discusses the January 2020 issue of the Journal of Trauma and Acute Care Surgery

Drs. Michael Yaffe and Hunter Moore discuss a potential treatment for COVID—19 seriously ill patients with ARDS using tPA. This is a companion piece to their article that is Open Access on the JTACS website and will appear in print in the June issue of the journal.

Journal of Trauma Editor in Chief, Dr. Gene Moore, discusses the December issue of the Journal of Trauma and Acute Care Surgery featuring selected Chest Wall papers

Journal of Trauma Editor in Chief, November issue of the Journal of Trauma and Acute Care Surgery dedicated to the Western Trauma Annual Meeting content

Journal of Trauma Editor in Chief, September issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, September issue of the Journal of Trauma and Acute Care Surgery

Dr. Gene Moore presents highlights from the August 2019 issue of JTACS

Dr. Gene Moore presents highlights from the July 2019 issue of JTACS dedicated to the EAST 2019 meeting. Dr. Moore also discusses articles from the MHSRS Supplement published this month

Journal of Trauma Editor in Chief, June 2019 issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, March issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, September issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, September issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, September issue of the Journal of Trauma and Acute Care Surgery

Listen as our Editor in Chief, Dr. Ernest Moore, discusses multiple articles from the Journal of Trauma’s August 2018 issue.

Listen as our Editor in Chief, Dr. Ernest Moore, discusses multiple articles from the Journal of Trauma’s July 2018 issue.

Listen as our Editor in Chief, Dr. Ernest Moore, discusses multiple articles from the Journal of Trauma’s June 2018 issue.

Listen as our Editor in Chief, Dr. Ernest Moore, discusses multiple articles from the Journal of Trauma’s May 2018 issue.

Listen as our Editor in Chief, Dr. Ernest Moore, discusses multiple articles from the Journal of Trauma’s April 2018 issue.

Journal of Trauma Editor in Chief, January issue of the Journal of Trauma and Acute Care Surgery

Listen as our Editor in Chief, Dr. Ernest Moore, discusses multiple articles from the Journal of Trauma’s February 2018 issue.

Journal of Trauma Editor in Chief, December issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, November issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, September issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, September issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, Dr. Gene Moore discusses several articles from the August issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, Dr. Gene Moore discusses several articles from the July issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, Dr. Gene Moore discusses several articles from the June issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, Dr. Gene Moore discusses several articles from the May issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, Dr. Gene Moore discusses several articles from the April issue of the Journal of Trauma and Acute Care Surgery.

Journal of Trauma Editor in Chief,  Dr. Gene Moore discusses several articles from the March issue of the Journal of Trauma and Acute Care Surgery

The first is by Dr. Clay Burlew and colleagues from Denver Health/University of Colorado who review their 11 years’ experience with preperitoneal pelvic packing for patients arriving in shock from pelvic fracture bleeding. The ensuing paper is by Dr. Andrea Lubitz et al from Temple University who report the compelling results of a sheep model in which inhales nitric oxide was employed to attenuate right heart failure following emergent pneumonectomy complicated by hemorrhagic shock. Dr. James Byrne and associates from the Sunnybrook Health Sciences Center in Toronto investigated the relative effectiveness of low-molecular weight heparin versus imfractionated heparin in preventing pulmonary embolism following major trauma. Dr. Matt Kutcher and his colleagues at the University of Pittsburgh provide an enlightening perspective on the critical role of acute care surgeons in major academic medical centers. Transcript

The lead article is Dr. Grace Rozycki’s Presidential Address entitled “A legacy of caring”. Dr. Rozycki provides a unique resource of fundamental concepts that summarize what the older generation; aka, the dinosaurs, would convey to the newer generation for their success in pursuing a fulfilling career. The ensuing paper is the Fitts Oration by Dr. Peggy Knudson who provides a comprehensive and compelling overview of the critical need to establish an enduring collaborative relationship between military and civilian trauma communities. Dr. Ronald Tesoriero and colleagues from the Cowley Shock Trauma Center in Baltimore undertook a retrospective review of patients with pelvic fractures who underwent angiography over ten years ending in 2012 to determine its current role in the acute management of life-threatening pelvic hemorrhage. In a related paper, Dr. Jeremy Juern and colleagues from the Medical College of Wisconsin performed a retrospective review to determine the role of CT contrast extravasation in predicting the need for angioembolization in patients with pelvic fractures. Dr. Christine Leeper et al from the Children’s Hospital at the University of Pittsburgh performed a prospective study of fibrinolysis phenotypes in children. Transcript

The lead paper is by Dr. Junichi Inoue and colleagues from the Tokyo Medical University who analyze the Japan Trauma Data Bank to determine the impact of REBOA. The next paper is by Dr. Vicente Undurraga and colleagues from the PROPPR group. In this subgroup the authors selected patients requiring emergency laparotomy, defined as within 90 minutes of hospital arrival, with the hypothesis that this high risk group would be most likely to benefit from an initial 1:1:1 transfusion strategy. The next paper by Dr. Shibani Pati and colleagues from the University of California at San Francisco and colleagues from Portland and Houston, examine the type of plasma to deliver to attenuate the endotheliopathy of trauma. Finally, I believe another timely report is by Dr. James Byrne and associates from the University of Toronto who analyze the impact of EMS prehospital times on trauma center outcome. Transcript

The issue begins with highlighting the National Academics of Sciences, Engineering, and Medicine (NASEM), formerly the National Academy of Sciences Institute of Medicine, report published in June 2016. This massive document is entitled “A National Trauma Care System: Integrating Military and Civilian Trauma Systems to Achieve Zero Preventable Deaths.” Dr. James Feeney and colleagues from St. Francis Hospital in Hartford used their Trauma Quality Improvement Project (TQR) registry to determine the impact of preinjury warfarin versus direct oral anticoagulants (including thrombin and Xa inhibitors) on outcome following blunt intracranial hemorrhage. Dr. Stefano Siboni and colleagues from LA County/USC examined the National Trauma Data Bank from 2007 to 2012 to determine outcome following isolated blunt pancreatic injury. Dr. Michael Wandling and associates from Northwestern, Sunnybrook, and Johns Hopkins provide an interesting analysis of police versus ground EMS transport for penetrating trauma using the National Trauma Data Bank from 2010 to 2012. Transcript

The lead article is by Dr. Bryan Morse with present or former colleagues at Grady Memorial Hospital who reviewed their experience with penetrating cardiac wounds over a 36 years period. Dr. Adrian Maung et al from the Yale School of Medicine analyzed the impact of new oral anticoagulation agents versus warfarin on postinjury mortality. Dr. Jonathan Meizoso and colleagues from the Ryder Trauma Center evaluated the time to operation on mortality for patients with GSWs arriving hypotensive (less than 110 mmHg). Dr. Morgan Schellenberg et al from Los Angeles County + University of Southern California Medical Center reviewed the evaluation of patients with pelvic GSWs. Check out the Injury Free Coalition for Kids supplement, representing their 20th annual meeting and, as usual, carefully edited by Dr. Joe Tepas. Transcript

The lead paper is by Dr. Joe DuBose and the AAST AORTA Study Group who maintain a registry representing eight Level I Trauma Centers. Dr. Howard Champion and associates from Sim Quest and colleagues from the University of Texas in Houston evaluated the US Department of Transportation Fatality Analysis Reporting System (FARS) database from 1978-2013 to determine location and time of death. Dr. Eitan Heldenberg and colleagues from the Israeli Trauma Group interrogated the Israeli National Trauma Registry to determine the incidence and impact of vascular injury on outcome in terror-related explosions. Dr. Josh Brown and colleagues from the University of Pittsburgh evaluated the role of prehospital lactate for triage in their air medical system. In a related paper, Dr. Janie Baxter et al from the Royal Infirmary in Edinburgh performed a systematic review of lactate levels in the ED predicting outcome, and concluded they are useful. Transcript

The lead article is by Dr. Naveen Sangji and colleagues from the Massachusetts General Hospital who propose an Emergency Surgery Acuity Score. Dr. Nakul Valsangkar et al from the Indiana University analyze the academic productivity of trauma/acute surgery faculty compared to general surgery and other specialty faculty. Dr. Martha Ingram and colleagues from Emory University evaluated the significance of hepatic or splenic blush on CT in children with blunt abdominal trauma. These conclusions are consistent with an accompanying paper by Dr. Stephen Fenton et al from the University of Utah who analyzed data from 20 participating centers in the Pediatric Emergency Care Applied Research Network. Dr. Sarah Sirajuddin and colleagues from the George Washington University evaluate the significance of platelet dysfunction identified in patients admitted with minor injury. Transcript

Dr. Ernest Moore discusses a roundup of papers first showcased at this year’s Eastern Association for the Surgery of Trauma annual meeting and published in the July 2016 issue of the Journal. The lead paper appropriately, is the presidential address by Dr. Stanley Kurek. Dr. Kurek provides a timely reflection on the challenges trauma surgeons face in maintaining their resilience. This is followed by the Oriens Lecture delivered by Dr. J. Don Jenkins. Dr. Jenkins offers a cogent perspective on leadership, reviewing the spectrum of leadership styles. Dr. Benjamin Miller et al from Vanderbilt University conducted a retrospective analysis of the impact of administering prehospital packed red cells in their helicopter service. In a related paper, Dr. Mark Yazer and colleagues from the Alleghany General Hospital review their initial ten months experience with transfusing cold-stored uncrossmatched whole blood, i.e., low titer group O positive blood that was leukoreduced with a platelet-sparing filter. Dr. David Jeffcoach et al from the University of Tennessee presented a provocative study on the role of CPR in profound hemorrhagic shock. Dr. Christine Leeper and colleagues from the Children’s Hospital at the University of Pittsburgh performed an analysis of trauma-induced coagulopathy in a pediatric group, i.e. less than the age of 18. Transcript

This issue is dedicated to a call to action for control of gun violence in the United States. In addition, this issue contains a comprehensive review by Dr. Peter Rhee and colleagues from the University of Arizona, which addresses science relevant to gunshot wounds including weapons, bullets, and their related ballistics Transcript

The lead article is the presidential address by Dr. Richard Falcone from the Cincinnati Children’s Hospital. Dr. Falcone’s central theme was the critical role of teamwork and team communication in caring for the injured child. The ensuing paper is the keynote lecture by Dr. Joe Tepas from the University of Florida at Jacksonville. Dr. Tepas provides an informative overview of the past, present, and future of pediatric trauma surgery. The next paper is by Dr. Sheila Hanson and colleagues from multiple pediatric surgical programs who address the ongoing debate of the appropriate prophylaxis for venous thromboembolism in the pediatric trauma patient. In a related paper, Dr. Ioannis Liras and colleagues from the University of Texas in Houston evaluated age related hypercoagulability in their rapid TEG database of greater than 7000 trauma activations from 2010-2013. I will conclude by suggesting careful reading of the AAST multi-institutional of hemorrhage from severe pelvic fractures authored by Dr. Todd Constanti and AAST members. Transcript

Welcome to the April issue of the Journal. The lead paper is by Dr. Junichi Inoue and colleagues from the Tokyo Medical University who analyze the Japan Trauma Data Bank to determine the impact of REBOA. REBOA has been used in Japan since 1990 and the national data bank was established in 2003. The next paper is by Dr. Vicente Undurraga and colleagues from the PROPPR group. In this subgroup the authors selected patients requiring emergency laparotomy, defined as within 90 minutes of hospital arrival, with the hypothesis that this high risk group would be most likely to benefit from an initial 1:1:1 transfusion strategy. The next paper by Dr. Shibani Pati and colleagues from the University of California at San Francisco and colleagues from Portland and Houston, examine the type of plasma to deliver to attenuate the endotheliopathy of trauma. Finally, I believe another timely report is by Dr. James Byrne and associates from the University of Toronto who analyze the impact of EMS prehospital times on trauma center outcome. The authors linked EMS data from the National EMS Information System to trauma centers using ACS TQIP by destination zip code. Transcript

The lead paper is by Dr. Kenji Inaba and colleagues from the AAST who performed a multicenter review of temporary intravascular shunts in civilian trauma centers from 2005-2013. Next, we have Dr. Rachel Russo and colleagues from the Air Force conducted studies in a swine model of controlled hemorrhage that demonstrated the concept of partial REBOA inflation in Zone I for extending the golden hour. Joining Drs. Inaba and Russo, we have Dr. Jamie Coleman and associates from the trauma services at Indiana University describe a series of traumatic abdominal wall hernias from 2002-2014. Dr. Jamie Coleman and associates from the trauma services at Indiana University describe a series of traumatic abdominal wall hernias from 2002-2014. Finally, I would highlight the paper by Dr. Thomas Schroeppel et al from the Presley Trauma Center at the University of Tennessee. This was a review of penetrating wounds from 1996 to 2014 that involve the duodenal. Transcript

The lead article is an AAST presentation by Dr. Fred Pieracci and colleagues from Denver Health/University of Colorado who report a prospective, controlled clinical study of rib fracture stabilization. Another timely AAST presentation was by Dr. Jennifer Hubbard et al from Fresno Community/University of California who report a retrospective review of the use of endotracheal tubes with subglottic secretion drainage. Dr. Daisy Chou and associates from Cedars-Sinai in Los Angeles analyze the impact of field intubation in patients with hemorrhagic shock. Finally, I would like to highlight the systematic review of REBOA in the management of hemorrhagic shock written by Dr. Jonathan Morrison from the Glasgow Royal Infirmary and colleagues from around the world. Transcript

As you know, we begin the year with some of the AAST presentations. Dr. L.D. Britt presented the AAST Fitz Lecture entitled acute care surgery. Is it time for a victory lap? Dr. Tom Scalea’s presidential address touched on these topics nostalgically. Dr. Josh Brown and colleagues from the University of Pittsburgh detail their AAST presentation on the impact of geographic distribution of trauma centers and their relationship to injury-related mortality. Dr. Brandon Chapman et al at Denver Health/University of Colorado described a chest CT based scoring system of rib fractures that are associated with pneumonia, mechanical ventilation, and need for a tracheostomy. Dr. Geoffrey Dobson from the James Cook University in Queensland provides a comprehensive review of a new impressive resuscitative adjunct adenosine, lidocaine, and magnesium (ALM). Transcript

The lead article is the Presidential Address of Dr. Chris Cocanour from the UC Davis Medical Center in Sacramento. The Earl Young Awardee was Hunter Moore from the University of Colorado Denver who, with his colleagues, has shown in a rodent model of severe hemorrhagic shock that plasma versus crystalloid resuscitation attenuates systemic hyperfibrinolysis. In the ensuing paper, Dr. Hasan Alam and his colleagues from the University of Michigan continue their innovative work with histone deacetylase inhibition by employing the selective inhibition of histone deacetylase 6 in rodent models of hemorrhagic shock. Dr. Alexis Moren and his colleagues from the PROMMT Study Group who employed their database of 1245 patients to identify massive transfusion based on rate of bleeding. Dr. Joseph Lopez and associates from the Baptist Medical Center at Wake Forest enlighten us with the implication of subcapsular hematomas in the management of blunt splenic trauma. Dr. Erik Olsen and colleagues from Scripps Mercy Hospital in San Diego who compared 5000 units of unfractionated heparin every eight hours to their standard enoxaparin 30 mg every 12 hours. Transcript

In the wake of the American College of Surgeons Committee on Trauma suggesting patient outcome is the same for Level I and Level II trauma centers, I believe a timely message is report by Dr. Jan Jansen from the Aberdeen Royal Infirmary and colleagues throughout Scotland who describe their comprehensive geospatial analysis of greater than 80,000 trauma patients over a year. Dr. Samuel Ross and associates from the Carolinas Medical Center in Charlotte, provide insight into the impact of normal saline versus Ringer’s lactate on resuscitation endpoints for hemorrhagic shock. Another interesting resuscitation paper was by Dr. Martin Ponschab et al from the Trauma Research Center in Salzburg. Dr. Elizabeth Benjamin and colleagues from the LA County Medical Center, investigate the risk of deep organ space infection after emergent bowel resection and anastomosis. The second paper is by Dr. Daniel Yeh et al from the Massachusetts General Hospital who focus on the clinical implications of gangrenous cholecystitis. Transcript

The lead paper presented at the AAST, is authored by Dr. Laura Moore from UT Houston along with colleagues from the Cowley Shock Trauma Center in Baltimore. In a related paper, presented at EAST, Dr. Sundeep Guliani et al from Virginia Commonwealth University demonstrated the reliability of ultrasound guided central aortic wire placement, thus, theoretically avoiding, the need for fluoroscopy for REBOA placement. Dr. David Notrica and colleagues from ATOMAC (which apparently is an abbreviation for Arizona-Texas-Oklahoma-Memphis-Arkansas Consortium), a group of ACS verified Level I pediatric trauma centers, reviewed the relevant literature with respective grading their recommendations for organ injuries ATOMAC proposed practice management guideline based on hemodynamic status rather than organ injury score formally employed in the American Pediatric Surgery Association guidelines that have been considered the standard for over two decades. Dr. Carl Wahlgren and Dr. Bjorn Kagsterman from the Karolinski Institute in Stockholm provide a review of pediatric vascular injuries managed in Sweden over the past 25 years. Transcript