In this episode we review the "lethal 6" and "hidden 6" chest injuries that comprise the deadly dozen of thoracic trauma. Mechanism of injury together with vital signs and findings from the physical exam should provide us with the data needed to identify life-threatening thoracic injuries on our primary survey. For hidden injuries, the diagnostic adjuncts required to identify these injuries are also discussed.Support the Show.

Episode 5 - The Deadly Dozen of Thoracic Trauma

Medical education podcast dedicated to providing high-quality, concise, and clinically relevant multimedia content spanning the spectrum of surgical critical care, emergency general & trauma surgery

Education

Training

Language Courses

Higher Education

K-12

Educational Technology

Medicine

Science & Medicine

Science

Health & Fitness

Life Sciences

Join us after hours at Dr. Bryan A. Cotton's pop-up bourbon bar at the AAST 2022 Meeting in Chicago. In this FANTASTIC & FUN episode, we talk amongst friends about cutting edge research at this year's meeting. To no one's surprise, coagulopathy, damage control resuscitation, whole blood, and factor replacement therapy just happen to be but a few of the topics discussed on Rounds.

Time Stamps:
00:12 AAST 2022 - Intro
00:42 Sex diamoprhisms in coagulation
01:52 Hemostatic profiles of female donors
02:48 Pediatric whole blood (WB) is safe
03:10 WB for TBI
03:31 Leukoreduction is unnecessary
05:30 TXA, TEG  and trauma
06:44 STAAMP trial
07:21 TXA: go early, big or go home
07:52 Calcium...early!
09:33 Canadian perspective on TXA and TEG – Neil Perry from London, ON
11:25 Nori Bradley from Edmonton, AB
13:53 Jordan Weinberg, not Canadian – Phoenix, AZ
16:12 Issues with WB – COMBAT vs PAMPer
17:31 Cold stored platelets
18:22 Rapid transfusers and whole blood: Only the strong survive!!
19:42 How are we doing with our resuscitation? 1:1:1 is just the beginning, not the end!
21:44 Timing is everything!
23:38 Plasma first resuscitation: “…God damn good!” -BAC
24:37 Dr. Joshua B. Brown - Pittsburgh, PA
25:31 More Canadian perspectives with Perry and Bradley
29:48 Less is best!
31:27 Prothrombin complex concentrate: Yay or nay?
32:18 More on the endotheliopathy of trauma
33:38 Just messing around and having a blast
34:22 What was the best bourbon tonight?

References:
CRASH-2 trial collaborators, Shakur H, Roberts I, Bautista R, Caballero J, Coats T, Dewan Y, El-Sayed H, Gogichaishvili T, Gupta S, Herrera J, Hunt B, Iribhogbe P, Izurieta M, Khamis H, Komolafe E, Marrero MA, Mejía-Mantilla J, Miranda J, Morales C, Olaomi O, Olldashi F, Perel P, Peto R, Ramana PV, Ravi RR, Yutthakasemsunt S. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet. 2010 Jul 3;376(9734):23-32. doi: 10.1016/S0140-6736(10)60835-5. Epub 2010 Jun 14. PMID: 20554319.

Gruen DS, Guyette FX, Brown JB, Okonkwo DO, Puccio AM, Campwala IK, Tessmer MT, Daley BJ, Miller RS, Harbrecht BG, Claridge JA, Phelan HA, Neal MD, Zuckerbraun BS, Yazer MH, Billiar TR, Sperry JL. Association of Prehospital Plasma With Survival in Patients With Traumatic Brain Injury: A Secondary Analysis of the PAMPer Cluster Randomized Clinical Trial. JAMA Netw Open. 2020 Oct 1;3(10):e2016869. doi: 10.1001/jamanetworkopen.2020.16869. PMID: 33057642; PMCID: PMC7563075.

Guyette FX, Brown JB, Zenati MS, Early-Young BJ, Adams PW, Eastridge BJ, Nirula R, Vercruysse GA, O'Keeffe T, Joseph B, Alarcon LH, Callaway CW, Zuckerbraun BS, Neal MD, Forsythe RM, Rosengart MR, Billiar TR, Yealy DM, Peitzman AB, Sperry JL; STAAMP Study Group. Tranexamic Acid During Prehospital Transport in Patients at Risk for Hemorrhage After Injury: A Double-blind, Placebo-Controlled, Randomized Clinical Trial. JAMA Surg. 2020 Oct 5;156(1):11–20. doi: 10.1001/jamasurg.2020.4350. Epub ahead of print. Erratum in: JAMA Surg. 2021 Jan 1;156(1):105. PMID: 33016996; PMCID: PMC7536625.

Moore HB, Moore EE, Chapman MP, McVaney K, Bryskiewicz G, Blechar R, Chin T, Burlew CC, Pieracci F, West FB, Fleming CD, Ghasabyan A, Chandler J, Silliman CC, Banerjee A, Sauaia A. Plasma-first resuscitation to treat haemorrhagic shock during emergency ground transportation in an urban area: a randomised trial. Lancet. 2018 Jul 28;392(10144):283-291. doi: 10.1016/S0140-6736(18)31553-8. Epub 2018 Jul 20. PMID: 30032977; PMCID: PMC6284829.

Pusateri AE, Moore EE, Moore HB, Le TD, Guyette FX, Chapman MP, Sauaia A, Ghasabyan A, Chandler J, McVaney K, Brown JB, Daley BJ, MSupport the show

Episode 55: AAST 2022 Hot Topics - From Sex Dimorphisms in Coagulation to TXA, TEG, Calcium and Beyond with Drs. Bryan A. Cotton, Neil Parry, Nori Bradley, Jordan Weinberg, Joshua Brown & Alyssa MacLe

In this episode we sit down with the Chief of Trauma, Surgical Critical Care, Burns,  & Acute Care Surgery at the University of Arizona, Dr. Bellal Joseph, who share with us his thoughts and research findings on hot topics including frailty, geriatric trauma, leadership, and more.Timestamps:00:12  Introductions01:30  What is frailty? Your physiologic NOT chronologic body.06:58  Injured elderly trauma patients can have good outcomes07:30  Trauma specific frailty in...

Episode 54: Frailty, Geriatric Trauma & TBI with Dr. Bellal Jospeh

In this episode, we talk all things critical care the one and only, Dr. Jean-Louis Vincent aka. JLV.  This episode is a MUST listen. We touch upon the evolution of early goal directed therapy, measures of fluid responsiveness, optimizing oxygen delivery, and the importance of integrating data points versus examining  them in isolation when caring for our critically ill and injured patients. This and MUCH MUCH more in arguably one of my favorite episodes to date!!Timestamps00:00 Intr...

Episode 53: Insights into Modern Critical Care with Dr. Jean-Louis Vincent: Part II

It's been a while! We are coming to you from our new studio in Victoria on Vancouver Island, BC. This Season is PACKED with incredible content, interviews and educational pearls designed to improve the quality of care that you are deliver daily at the bedside to your patients and their loved ones.Support the Show.

Season 3 Trailer

In this episode, we discuss the overarching importance of AVOIDING iatrogenic harm in the ICU with arguably one of the world's leading experts in critical care medicine, the one and only, Dr. Jean-Louis Vincent aka. JLV.Tune in as Dr. Vincent shares with us the importance of having a systematic, problem-based approach to patient care delivery which, of course, involves giving our patients a FAST HUG every day!Time Stamps:2:10 LA Critical Care and Differences between Europe versus USA4:04 COVI...

Episode 5 - The Deadly Dozen of Thoracic Trauma

Download our free app to listen on your phone