Journal of Trauma and Acute Care Surgery - Trauma Loupes Podcast

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.

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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.

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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

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.

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.

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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.

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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).

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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.

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