TRAUMA-ING

In this episode, we sit down with Winny Li from Sunnybrook Health Sciences Centre to explore the Trauma Team Video Review (TTVR) program and its growing role in trauma care.Winny Li is a clinician and quality improvement leader with expertise in trauma systems, simulation, and patient safety. She has been closely involved in the development and implementation of video review initiatives aimed at improving team performance and clinical outcomes.We start by breaking down what trauma video review programs are and how they work in practice. The conversation highlights how these programs create powerful opportunities for learning, system improvement, and enhanced team communication.We also dive into the real-world challenges of implementing TTVR, including concerns around privacy, medicolegal risk, cost, and cultural resistance. Importantly, we discuss practical solutions and strategies that have helped overcome these barriers, including stakeholder engagement, governance frameworks, and fostering a culture of psychological safety.Whether you're involved in trauma care, education, or quality improvement, this episode offers valuable insights into how video review can transform team learning and patient care.For more FOAM trauma stuff go to www.trauma-ing.com

In this episode, we sit down with Dr. Andrew W Kirkpatrick, Major (retired), trauma surgeon and critical care specialist based in Calgary, and Dr. Shane Smith, Lieutenant Colonel and vascular, trauma, and general surgeon at Western University.Dr. Kirkpatrick was a key pioneer in the development of the RAPTOR (Resuscitation with Angiography, Percutaneous Techniques, and Operative Resuscitations) suite in Calgary, one of the earliest and most influential hybrid trauma resuscitation environments in North America. Together, we explore the evolution of RAPTOR/THOR (Trauma Hybrid Operating Room) concepts and how they are reshaping the management of severely injured patients.We discuss the core benefits of these hybrid environments—most notably the ability to deliver definitive hemorrhage control faster by combining operative and endovascular capabilities in a single location, while minimizing delays and risks associated with patient transfers.We also examine an important limitation: without thoughtful, forward-looking design, these suites risk becoming outdated. Rapid advances in standalone angiography and interventional technologies can outpace earlier-generation RAPTOR builds, highlighting the importance of flexibility and future-proofing when investing in these high-resource systems.Check out www.trauma-ing.com for more FOAM trauma stuff

We sit down with Amber Humes and Dr. John Armstrong, experts in MCI's to discuss how TNS and our health systems are preparing for these events. What is an MCI? How do we triage patients, how does the care differ from standard care?For more trauma stuff go to www.trauma-ing.com

We sit down with TTL and trauma consultant Dr. Sean Hurley to discuss his approach to bedside imaging and CT scan in trauma patients. We talk about utility of POCUS and Xray at the bedside, and the various different CT imaging modalities and when to use them.For more trauma stuff go to www.trauma-ing.com

James and Rob go live again for an Ask Me Anything episode. They tackle such questions as optimal use of TXA, permissive hypotension, hand over, and whether Rob has ever “moshed” at a Metallica concert. For more FOAM trauma stuff go to www.trauma-ing.com

In this episode of Trauma-ing, hosts James Gould and Rob Green are joined by Mike Rivers-Bowerman, a staff interventionalist at the QEII, for an in-depth discussion on the role of Interventional Radiology (IR) in trauma care. We explore what IR is, when and why it should be used in the trauma setting, and walk through some of the key techniques commonly employed. The conversation also covers important considerations for post-IR monitoring, highlighting how IR integrates into the broader trauma pathway and improves patient outcomes.For more FOAM trauma stuff go to www.trauma-ing.com

In this Trauma-ing Resus Rewind, we replay a standout episode from The Resus Course featuring Dr. Eve Purdy on relational coordination in resuscitation. The conversation explores how high-performing resus teams depend not just on technical skill, but on shared goals, shared knowledge, and mutual respect across disciplines. Eve breaks down why communication, role clarity, and relationships matter most when stakes are high, and how investing in these human factors improves patient outcomes and team performance. A timely reminder that great resuscitation is a team sport—and relationships are part of the resus toolkit.For more trauma resus stuff go to www.trauma-ing.com

In this replayed episode from THE RESUS COURSE podcast, Dr. Sean Hurley and James Gould discuss a practical, resuscitation-focused approach to penetrating neck trauma, covering how and when to intubate, how to recognize hard and soft signs of significant injury, and strategies for investigating and managing airway, vascular, and digestive tract injuries in it’s initial resuscitation phaseFor more trauma resus stuff go to www.trauma-ing.com

In this trauma-ing episode, we sit down with Dr. Paul Atkinson to explore compassionomics—the science behind why compassion matters in healthcare. Dr. Atkinson breaks down the critical differences between sympathy, empathy, and compassion, and explains how compassion goes beyond feeling to action. We discuss the growing evidence that compassionate care improves patient outcomes, strengthens trust in our trauma system, and enhances team performance. Importantly, he also reframes compassion as a protective strategy for clinicians, showing how it can reduce moral distress and help guard against burnout rather than contribute to it. This episode is a timely reminder that compassion is not a soft skill, but a measurable, system-level intervention that benefits patients and providers alike.For more FOAM trauma stuff go to www.trauma-ing.com

James and Rob sit down with Dr. Matthew Mackin for a Trauma-ing episode that digs into his recent trauma fellowship at the legendary R Adams Cowley Shock Trauma Center in Baltimore. Now back home as one of our trauma team leaders and trauma consultants—and bringing his anesthesiology expertise with him—Matt shares what life was really like inside one of the busiest trauma centres in the world. We explore the practices and culture he hopes to transplant into our own system, including a renewed emphasis on subclavian lines during resuscitation, broader use of regional anesthesia, and several other high-impact habits from Shock Trauma’s playbook.For more FOAM trauma related content head to www.trauma-ing.com

In this Trauma-ing Journal Club episode, we break down three timely studies shaping trauma care at the bedside and in the bay. First, we look at Perera et al.’s prehospital comparison of non-invasive versus arterial blood pressure monitoring, where NIBP consistently missed the mark in both shock and hypertension—who then should get art lines and when? We then dive into the TRAUMOX2 randomized trial, which challenges our instinct to “turn the oxygen up,” showing no mortality difference between restrictive and liberal oxygen strategies but hinting at fewer pulmonary complications with moderate targets. Finally, we unpack Burt et al.’s meta-analysis on early fibrinogen replacement in traumatic haemorrhage, finding no clear mortality or transfusion benefit despite its widespread use and highlighting the need for stronger evidence in the sickest, most coagulopathic patients.Go to www.trauma-ing.com for more FOAM trauma stuff

In this special live episode of Trauma-ing, James and Rob sat down with Mitchell and his dad, Bob, to revisit their incredible journey following a devastating MVC five years ago that left Mitchell with a severe TBI. Initially, his injuries were so grave that organ donation was discussed—but thanks to the dedication of our trauma system and the care teams across the QEII Health Sciences Center, he’s now living independently. Together, we explored their experience from the moment of the crash through rehabilitation, highlighting what went well, what mattered most to them along the way, and their advice to healthcare providers caring for patients and families facing similar life-altering injuries.

In this special episode of Trauma-ing with Dr. James Gould and Dr. Rob Green, we unpack the new Trauma Nova Scotia (TNS) cervical spine clearance pathway—a bold, evidence-driven initiative aimed at optimizing cervical spine assessment in trauma patients. Join Dr. Gould and Dr. Green as they walk you through the rationale behind the pathwayFor more FOAM trauma related content go to www.trauma-ing.com

In this Trauma-ing episode, Rob and I dig into the Massive Hemorrhage Protocol—when to activate, balancing blood products, and key elements like calcium, fibrinogen, and labs—along with a look at the lethal triad versus the lethal diamond and how these shape bedside decisions.Check out www.trauma-ing.com for more FOAM trauma content

Welcome to the very first Rapid Infuser episode—where we give you a fast push of trauma knowledge, straight lined into your brain. This time we’re talking about the rapid infusers themselves: the Belmont and the Level 1. We’ll hit the highlights on how they work, and drop a few clinical pearls that’ll help you keep blood moving when it matters most. Short, sharp, and just enough volume to keep your brain perfused. Check out this link here for steps on priming the BelmontFor more FOAM trauma related content go to www.trauma-ing.com

In this episode, Dr. James Gould and Dr. Rob Green are joined by trauma experts Dr. Luis Da Luz and Dr. Christian Malo for a lively discussion of the Top Ten Trauma Papers of 2024. The team tackles three of the standout publications from this year’s list, diving into the clinical relevance, methodology, and controversies behind the data.This is the third installment in the podcast’s Journal Club series — perfect for trauma clinicians, learners, and anyone interested in how evidence shapes practice on the front lines.Head to www.trauma-ing.com for more trauma related FOAM. And for a complete list of the top 10 trauma papers of 2024

In this episode, James Gould and Dr. Rob Green are joined by Steve Crocker, Critical Care Paramedic with EHS LifeFlight, for a deep dive into the world of critical care transport in Nova Scotia. Originally recorded as part of a Dalhousie University Critical Care Medicine Fellow Half-Day, this candid discussion explores how trauma patients move through our system—from the roadside to tertiary care. With insights from Steve’s front-line experience and reflections from our CCM fellows, we unpack the logistics, challenges, and collaborative efforts that define high-stakes transport in our region.For more FOAM trauma related content go to www.trauma-ing.com

In this episode of Trauma-ing, clinical pharmacist Alex Smithers joins us to break down antibiotic management for open fractures. We cover the go-to use of cefazolin, then dig into how antibiotic choices shift based on patient risk factors and the Gustilo-Anderson classification. A practical, case-based discussion for anyone involved in the early management of traumatic injuries.For more FOAM trauma related content head to www.trauma-ing.com

In this episode, Dr. Jason Emsley joins us to tackle one of the most challenging areas of emergency care—pediatric trauma resuscitation. Are kids just small adults, or do they require a fundamentally different approach? We explore the key differences in anatomy, physiology, and clinical decision-making, while also discussing practical strategies for high-stakes pediatric trauma situations. Whether you’re a seasoned trauma provider or new to pediatrics, this episode will challenge assumptions and sharpen your resuscitation skills.For more FOAM trauma related content head to www.trauma-ing.com

In this episode, Dr. Safraz Mohammed joins us to break down the critical aspects of spinal cord injury—from initial presentation in the emergency department to acute management strategies. We explore key decision points, common pitfalls, and evidence-informed practices that can improve outcomes. Whether you’re at the bedside or in training, this discussion offers practical insights for managing one of trauma’s most high-stakes scenarios.For more trauma-focused content and resources, visit www.trauma-ing.com.

In this Trauma-Pharma segment, clinical pharmacist Alex Smithers joins us again to unpack the approach to seizure prophylaxis in traumatic brain injury (TBI). She covers who actually needs seizure prevention, why Keppra (levetiracetam) is commonly used, and how to get the dosing right. Practical, evidence-based, and focused — everything you need to sharpen your trauma care.Check out www.trauma-ing.com for more FOAM trauma related content

Join us as Lynda Foster and Dr. Leeor Sommer share innovative approaches to geriatric trauma care they’ve implemented at their hospital. From enhanced triage protocols to optimized pain management, this episode is packed with insights you won’t want to miss!For more trauma content, check out www.trauma-ing.com

The amazingly impressive Dr. Stephanie Smith is here to talk about preparing yourself and your team for a trauma patient. She explores the stress response and how to combat that. Drawing for her experiences as am emerg doc, military doc, former trauma nurse and competitive triathlete and adventure racer. Check out her other content on YouTube: https://youtube.com/@stephaniesmith3790?si=HEi3q3EeNFsJjMrU For more FOAM trauma related content go to www.trauma-ing.com

In this episode we chat with Alex Smithers, trauma pharmacist, about the importance of calcium in trauma care. For more FOAM trauma related content go to www.trauma-ing.com

James reads an awesome poem to Rob, and then they talk about permissive hypotension in trauma resuscitations. What is the ideal MAP or SBP in hemorrhagic shock? what about with a head injury? What if your patient old? What if you have no blood products?For more FOAM trauma related content head to www.trauma-ing.com or subscribe to the podcast

Rob and James chat about the uselessness of a DRE in trauma resuscitation. They cover a recent systematic review on the test characteristics of the DRE and make a strong plea to providers to abandon this invasive, unnecessary test.For more free open access trauma related content, subscribe to the podcast and/or head to www.trauma-ing.com

James and Rob cover a paper on DSI vs RSI in trauma patients. Essentially, does giving ketamine to dissociate patients for preoxygenation of 3 minutes prior to paralytic improve incidence of peri-intubation hypoxia and other adverse events. Take home - ketamine in this population is typically hemodynamically neutral and maintains spontaneous breathing. Its use in trauma airway management can facilitate not only adequate preoxygenation, but also patient assessment, and other resuscitative measures before intubation. For more FOAM trauma related content head to www.trauma-ing.com

James and Rob cover audience questions including prebreifing your trauma team, decompressing chests, and all the subtle details of a massive hemorrhage protocol.Stay tuned for more trauma related FOAM at our website www.trauma-ing.com or listen wherever you get your podcasts!