Trauma with Karim Brohi

Karim is a Professor of Trauma Sciences in the Blizzard Institute, Barts and the London School of Medicine & Dentistry, and Consultant Trauma & Vascular Surgeon at Barts Health NHS Trust. He is also the director of the pan London trauma system. In this episode we look at: Monitoring modalities and diagnostics (the advent of pre-hospital and in-hospital US, in-hospital CT & MRI) that have led to an improvement in outcome. Whether front loading pre-hospital critical care teams with more interventions had a net positive impact on survival to discharge. The benefit of numerical targets for physiology such as blood pressure in resuscitation or more organic end-points such as mentation/AVPU or pallor/diaphoresis/respiratory rate are more useful? The adverse effects of complex interventional involvement in pelvic blunt injury (such as REBOA or ECMO) are worth the investment at point of injury or whether they are better placed in centres of specialism? What we can do to prevent penetrating trauma as the upward trend in penetrating disease continues? Look at the advances in rehabilitation services Vs impact on survival to discharge in comparison to pre-hospital, & surgical intervention? Some of the more common injury patterns that exist more-so now compared to when Karim first started as a surgeon. The recent challenges faced within the Pan London Trauma Networks. The advent of Acute Traumatic Coagulopathy (ATC) in the early 2000’s and its consequential impact on survival since. Where Karim sees the largest gains that can be made in pre-hospital care? What Karim looks for potential in other junior clinicians  Advice that Karim would pass on to someone starting their medical career. Aspects of mindset and approach that have changed in Karim's practice over the last 10 years  I hope you enjoy the episode.