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?

Traumacast

Rural Trauma Care: Part 1

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. 

COVID-19 Part 05 - What Have We Learned

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?

What's the Whole Story About Whole Blood Transfusion?

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! 

Vascular Trauma - Part 2

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! 

Vascular Trauma

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 

Management of the Burn Patient

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 

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

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/

COVID-19 Part 03 - Palliative Care

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."

COVID-19 Part 02

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/

COVID-19 Part 01

Welcome Red Hoffman, our newest Traumacast moderator!!  She interviews 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

American Trauma Society - Trauma Survivors Network

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!

33rd EAST Annual Scientific Assembly Compilation Traumacast

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.

Highlights from the 2019 Pediatric Trauma Society Annual Meeting

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.

All About Hemothorax: Does Chest Tube Size Matter?

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

Vasopressin in Hemorrhage Resuscitation

A series of 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. Select EAST Traumacasts now 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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Traumacast

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