Assessment and triage in an austere environment represent a major challenge in casualty care. Modern conflicts involve a significant proportion of multiple wounds, either superficial or penetrating, which complicate clinical […]» Read more
REBOA is used for temporary aortic occlusion of trauma patients in the management of non-compressible hemorrhage. Previous studies have focused on how to properly perform REBOA in the trauma environment […]» Read more
The implementation of a pathway and care bundle for the management of acute occlusive arterial mesenteric ischemia reduced mortality.
Acute mesenteric ischemia (AMI) is a disease with high mortality and requires a multidisciplinary approach for effective management. A pathway and care bundle were developed and implemented with the objective […]» Read more
Whole blood (WB) has shown promise in pediatric trauma resuscitation following its prominent role in the resuscitation of adult trauma patients. Although WB in children has been shown to be […]» Read more
The incidence of and mortality due to acute kidney injury (AKI) is high in patients with traumatic shock. However, it is unclear how hemorrhage and trauma synergistically affect renal function, […]» Read more
The COVID-19 pandemic reshaped the healthcare system in 2020. COVID-19 infection has been associated with poor outcomes after orthopedic surgery and elective, general surgery, but the impact of COVID-19 on […]» Read more
Penetrating cervical carotid artery injury (CCAI) is an uncommon but high stakes scenario associated with stroke and death. The objective of this study is to characterize and compare penetrating carotid […]» Read more
Best Case/Worst Case for the Trauma ICU: Development and Pilot Testing of a Communication Tool for Older Adults with Traumatic Injury.
“Best Case/Worst Case” (BC/WC) is a communication tool to support shared decision making in older adults with surgical illness. We aimed to adapt and test BC/WC for use with critically […]» Read more
Don’t Mess with the Pancreas! A Multicenter Analysis of the Management of Low-Grade Pancreatic Injuries.
Current guidelines recommend nonoperative management (NOM) of low-grade (AAST-OIS grade I-II) pancreatic injuries (LGPIs), and drainage rather than resection for those undergoing operative management, but they are based on low […]» Read more
Pain management is critical for optimal recovery after trauma. Previous work at our institution revealed differences in pain assessment by patient language, which may impact management. This study aimed to […]» Read more
As the United States withdraws from overseas conflicts, general surgeons remain deployed in support of global operations. Surgeons and surgical teams are foundational to combat casualty care; however, currently there […]» Read more
Pain management for casualties receiving life-saving interventions in the prehospital scenario – raising awareness of our human nature.
Life-saving interventions (LSIs) are the hallmark of medical care in trauma casualties, reducing mortality and morbidity. Analgesia is another essential treatment, which has been shown to improve outcomes and decrease […]» Read more
Medics have numerous responsibilities in the combat theater, which include performing life-saving interventions, providing basic medical and nursing care, and caring for casualties in a variety of scenarios unique to […]» Read more
ROLE OF ALBUMIN ON ENDOTHELIAL BASEMENT MEMBRANE AND HEMOSTASIS IN A RAT MODEL OF HEMORRHAGIC SHOCK.
We sought to determine the extent of loss of endothelial basement membrane (BM), leukocyte recruitment and changes in coagulation after hemorrhagic shock (HS), followed by limited-volume resuscitation (LVR) with 5% […]» Read more
Non-compressible hemorrhage is a leading cause of preventable death in civilian and military trauma populations. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is a promising method for controlling non-compressible […]» Read more
Military experience has shown low-titer O whole blood (LTOWB) to be safe and beneficial in the resuscitation of hemorrhaging trauma patients. However, few civilian centers utilize LTOWB for trauma resuscitation. […]» Read more
Saving the brain after mild-to-moderate traumatic injury: a report on new insights of the physiology underlying adequate maintenance of cerebral perfusion.
Traumatic brain injury (TBI) is associated with increased morbidity and mortality in civilian trauma and battlefield settings. TBI has been classified across a continuum of dysfunctions, with as much as […]» Read more
The timing of amputation of mangled lower extremities does not predict post-injury outcomes and mortality: a retrospective analysis from the ACS TQIP database.
While limb salvage does not result in improved functional outcomes among patients with a mangled lower extremity, the impact of attempted limb salvage on mortality and complications is poorly understood. […]» Read more
The current study explores the trends in the application of combat casualty care following the publication of clinical practice guidelines in five domains over thirteen years.The Israel Defense Forces Trauma […]» Read more
Trends in pre-hospital pain management following the introduction of new clinical practice guidelines.
Early pain treatment following injury has been shown to improve long-term outcomes, while untreated pain can facilitate higher post-traumatic stress disorder (PTSD) rates and worsen outcomes. Nonetheless, trauma casualties frequently […]» Read more
Venous Thromboembolic Risk Stratification in Pediatric Trauma: A Pediatric Trauma Society Research Committee Multicenter Analysis.
Venous thromboembolism (VTE) in injured children is rare, but its consequences are significant. Several risk stratification algorithms for VTE in pediatric trauma exist with little consensus, and all are hindered […]» Read more
Blunt cerebrovascular injuries: Outcomes from the American Association for the Surgery of Trauma PROspective Observational Vascular Injury Treatment (PROOVIT) multicenter registry.
Administering antithrombotics (AT) to the multiply injured patient with blunt cerebrovascular injury (BCVI) requires a thoughtful assessment of the risk of stroke and death associated with nontreatment. Large, multicenter analysis […]» Read more
Development of a field artificial intelligence triage tool: Confidence in the prediction of shock, transfusion, and definitive surgical therapy in patients with truncal gunshot wounds.
In-field triage tools for trauma patients are limited by availability of information, linear risk classification, and a lack of confidence reporting. We therefore set out to develop and test a […]» Read more
Emergency general surgery (EGS) is a high-volume and high-risk surgical service. Interhospital variation in EGS outcomes exists, but there is disagreement in the literature as to whether hospital admission volume […]» Read more
Empowering the affected: Informing community-based solutions through interviews with survivors of interpersonal firearm violence-Perspectives of survivors of firearm injuries.
Firearm violence remains epidemic in the United States, with interpersonal gun violence leading to significant morbidity and mortality. Interpersonal violence has strong associations with social determinants of health, and community-specific […]» Read more
Isolated blunt renal artery injury (BRAI) is uncommon. Treatment options include observation, nephrectomy, surgical reconstruction and endovascular stenting. Over the last decade, there has been an increasing use of angiointervention […]» Read more
Extrathoracic multiple trauma dysregulates neutrophil function and exacerbates pneumonia-induced lung injury.
Forty percent of critically ill trauma patients will develop an infectious complication. Pneumonia is the most common cause of death of trauma patients surviving their initial insult. We previously demonstrated […]» Read more
Impact of US hospital center and interhospital transfer on spinal cord injury management: An analysis of the National Trauma Data Bank.
Traumatic spinal cord injury (SCI) is a serious public health problem. Outcomes are determined by severity of immediate injury, mitigation of secondary downstream effects, and rehabilitation. This study aimed to […]» Read more
Improving trauma tertiary survey performance and missed injury identification using an education-based quality improvement initiative.
Performance of a trauma tertiary survey (TTS) reduces rates of missed injuries, but performance has been inconsistent at trauma centers. The objectives of this study were to assess whether quality […]» Read more
Making the call in the field: Validating emergency medical services identification of anatomic trauma triage criteria.
The National Field Triage Guidelines were created to inform triage decisions by emergency medical services (EMS) providers and include eight anatomic injuries that prompt transportation to a Level I/II trauma […]» Read more