Trauma Loupes

Journal of Trauma Guest Editors Dr. Todd Rasmussen and Dr. Jeremy Cannon discuss insightful and compelling articles that will appear in the August Military Supplement that will accompany the regular journal August issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, Dr. Gene Moore, discusses the February 2020 issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, Dr. Gene Moore, discusses the May 2020 issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, Dr. Gene Moore, discusses the March 2020 issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, Dr. Gene Moore, discusses the January 2020 issue of the Journal of Trauma and Acute Care Surgery

Drs. Michael Yaffe and Hunter Moore discuss a potential treatment for COVID—19 seriously ill patients with ARDS using tPA.  This is a companion piece to their article that is Open Access on the JTACS website and will appear in print in the June issue of the journal.

Journal of Trauma Editor in Chief, Dr. Gene Moore, discusses the December issue of the Journal of Trauma and Acute Care Surgery featuring selected Chest Wall papers

Journal of Trauma Editor in Chief, November issue of the Journal of Trauma and Acute Care Surgery dedicated to the Western Trauma Annual Meeting content

Journal of Trauma Editor in Chief, September issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, September issue of the Journal of Trauma and Acute Care Surgery

Dr. Gene Moore presents highlights from the August 2019 issue of JTACS  

Dr. Gene Moore presents highlights from the July 2019 issue of JTACS dedicated to the EAST 2019 meeting.  Dr. Moore also discusses articles from the MHSRS Supplement published this month  

Journal of Trauma Editor in Chief, June 2019  issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, March issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, September issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, September issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, September issue of the Journal of Trauma and Acute Care Surgery

Listen as our Editor in Chief, Dr. Ernest Moore, discusses multiple articles from the Journal of Trauma's August 2018 issue.

Listen as our Editor in Chief, Dr. Ernest Moore, discusses multiple articles from the Journal of Trauma's July 2018 issue.

Listen as our Editor in Chief, Dr. Ernest Moore, discusses multiple articles from the Journal of Trauma's June 2018 issue.

Listen as our Editor in Chief, Dr. Ernest Moore, discusses multiple articles from the Journal of Trauma's May 2018 issue.

Listen as our Editor in Chief, Dr. Ernest Moore, discusses multiple articles from the Journal of Trauma's April 2018 issue.

Journal of Trauma Editor in Chief, January issue of the Journal of Trauma and Acute Care Surgery

Listen as our Editor in Chief, Dr. Ernest Moore, discusses multiple articles from the Journal of Trauma's February 2018 issue.

Journal of Trauma Editor in Chief, December issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, November issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, September issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, September issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, Dr. Gene Moore discusses several articles from the August issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, Dr. Gene Moore discusses several articles from the July issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, Dr. Gene Moore discusses several articles from the June issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, Dr. Gene Moore discusses several articles from the May issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief, Dr. Gene Moore discusses several articles from the March issue of the Journal of Trauma and Acute Care Surgery

Journal of Trauma Editor in Chief,  Dr. Gene Moore discusses several articles from the March issue of the Journal of Trauma and Acute Care Surgery

The first is by Dr. Clay Burlew and colleagues from Denver Health/University of Colorado who review their 11 years' experience with preperitoneal pelvic packing for patients arriving in shock from pelvic fracture bleeding. The ensuing paper is by Dr. Andrea Lubitz et al from Temple University who report the compelling results of a sheep model in which inhales nitric oxide was employed to attenuate right heart failure following emergent pneumonectomy complicated by hemorrhagic shock. Dr. James Byrne and associates from the Sunnybrook Health Sciences Center in Toronto investigated the relative effectiveness of low-molecular weight heparin versus imfractionated heparin in preventing pulmonary embolism following major trauma. Dr. Matt Kutcher and his colleagues at the University of Pittsburgh provide an enlightening perspective on the critical role of acute care surgeons in major academic medical centers.

The lead article is by Dr. Bryan Morse with present or former colleagues at Grady Memorial Hospital who reviewed their experience with penetrating cardiac wounds over a 36 years period.   Dr. Adrian Maung et al from the Yale School of Medicine analyzed the impact of new oral anticoagulation agents versus warfarin on postinjury mortality.  Dr. Jonathan Meizoso and colleagues from the Ryder Trauma Center evaluated the time to operation on mortality for patients with GSWs arriving hypotensive (less than 110 mmHg). Dr. Morgan Schellenberg et al from Los Angeles County + University of Southern California Medical Center reviewed the evaluation of patients with pelvic GSWs.  Check out the Injury Free Coalition for Kids supplement, representing their 20th annual meeting and, as usual, carefully edited by Dr. Joe Tepas.

The lead paper is by Dr. Joe DuBose and the AAST AORTA Study Group who maintain a registry representing eight Level I Trauma Centers. Dr. Howard Champion and associates from Sim Quest and colleagues from the University of Texas in Houston evaluated the US Department of Transportation Fatality Analysis Reporting System (FARS) database from 1978-2013 to determine location and time of death.  Dr. Eitan Heldenberg and colleagues from the Israeli Trauma Group interrogated the Israeli National Trauma Registry to determine the incidence and impact of vascular injury on outcome in terror-related explosions. Dr. Josh Brown and colleagues from the University of Pittsburgh evaluated the role of prehospital lactate for triage in their air medical system.  In a related paper, Dr. Janie Baxter et al from the Royal Infirmary in Edinburgh performed a systematic review of lactate levels in the ED predicting outcome, and concluded they are useful. 

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.

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. 

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.

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).

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.