Audio interviews addressing upcoming research and its application to the injured patient, education efforts related to trauma, and novel methods in the management of injury.

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Podcasts Currently Available

EAST Traumacast logo FFP Resuscitation in Burn: Are Your Patients Missing Out On This Benefit? - #162

Join Drs. Cardenas and Dudas discuss the history, role, potential benefits and implementation of FFP resuscitation as a strategy in burn patients with burn specialists Drs. Robel Beyene, Colonel Jennifer Gurney and Tina Palmieri.  What other options are being studied and what is on the horizon?  Don’t miss this information packed discussion!

Supplemental Material: Fellowships - The Eastern Association for the Surgery of Trauma

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EAST Traumacast logo What's the Whole Story About Whole Blood Transfusion? - #138

Welcome Dr. Lauren Dudas, our next guest moderator, as she interviews Dr. Don Jenkins and Dr. Dan Grabo on whole blood.  Is it better than component transfusion? What would it take to start a program at your institution? What does the future hold for your transplant, ruptured AAA and OB patients?

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EAST Traumacast logo Vasopressin in Hemorrhage Resuscitation - #126

Pressors in trauma resuscitation? Heresy!  Or is it…?  Dr. Carrie Sims discusses her recently published study showing use of low-dose vasopressin in the trauma bay resulted in lower utilization of blood products, with equivalent outcomes.  Dr. Sims also discusses how she was able to get this study through the IRB with exception from informed consent (EFIC), a major hurdle for high-quality trauma research.

Supplemental Information
Effect of low-dose supplementation of arginine vasopressin on need for blood product transfusions in patients with trauma and hemorrhagic shock

Arginine vasopressin, copeptin, and the development of relative AVP deficiency in hemorrhagic shock

The pathogenesis of vasodilatory shock

Early use of vasopressors after injury: caution before constriction

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EAST Traumacast logo A Randomized Trial of TEG versus Conventional Coagulation Tests to Guide Massive Transfusion in Bleeding Trauma Patients: Interview with Dr. Gene Moore - Podcast #62

Viscoelastic assays for assessing the coagulation system have been around for decades, but have recently seen a surge in interest and research in the trauma community. Thromboelastography (TEG) and Rotational Thromboelastometry (ROTEM) provide a real-time assessment of multiple aspects and factors involved in clot initiation, development and maturation, and then breakdown or lysis. Many trauma centers have begun incorporating viscoelastic testing in the initial evaluation of injured patients, particularly among those with known or suspected active bleeding. Although TEG/ROTEM have many theoretical advantes compared to standard or conventional coagulation assays, there have been no prospective controlled trials comparing them head to head until now. We interviewed Dr. Gene Moore, the senior author and principal investigator on a recently published prospective randomized trial comparing the utility and associated outcomes of massive transfusions guided by TEG versus those guided by conventional coagulation assays. This is a must-read paper for all trauma providers, and Dr. Moore provides some great additional insights into the study design, results, and interpretation.

Supplemental Materials:
Goal-directed Hemostatic Resuscitation of Trauma-induced Coagulopathy: A Pragmatic Randomized Clinical Trial Comparing a Viscoelastic Assay to Conventional Coagulation Assays
Annals of Surgery: June 2016 - Volume 263 - Issue 6 - p 1051–1059

EAST Online Education Activity  - TEG/ROTEM Testing in Trauma & Transfusion Management

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EAST Traumacast logo Whole Blood Transfusion: Everything Old is New Again - Podcast #60

Whole blood transfusion, once the norm, is once again rising to the forefront of hemorrhage resuscitation science.  In this podcast, Drs. Philip Spinella and Alan Murdock share their expert thoughts and opinions regarding the rationale for whole blood transfusion.  After listening, you just may want to start using whole blood in your hospital.

Articles Referenced:

  1. Cotton BA, Podbielski J, Camp E, Welch T, del Junco D, Bai Y, Hobbs R, Scroggins J, Hartwell B, Kozar RA, Wade CE, Holcomb JB; Early Whole Blood Investigators. A randomized controlled pilot trial of modified whole blood versus component therapy in severely injured patients requiring large volume transfusions. Ann Surg. 2013 Oct;258(4):527-32; discussion 532-3
  2. Spinella PC, Pidcoke HF, Strandenes G, Hervig T, Fisher A, Jenkins D, Yazer M, Stubbs J, Murdock A, Sailliol A, Ness PM, Cap AP. Whole blood for hemostatic resuscitation of major bleeding. Transfusion. 2016 Apr;56 Suppl 2:S190-202.
  3. Blumberg BS, Kuvin SF, Robinson JC, Teitelbaum JM, Contacos PG.  Alterations in Haptoglobin Levels. JAMA. 1963;184(13):1021-1023
  4. Nessen SC, Eastridge BJ, Cronk D, Craig RM, Berséus O, Ellison R, Remick K, Seery J, Shah A, Spinella PC. Fresh whole blood use by forward surgical teams in  Afghanistan is associated with improved survival compared to component therapy without platelets. Transfusion. 2013 Jan;53 Suppl 1:107S-113S.
  5. Strandenes G, Berséus O, Cap AP, Hervig T, Reade M, Prat N, Sailliol A, Gonzales R, Simon CD, Ness P, Doughty HA, Spinella PC, Kristoffersen EK. Low titer group O whole blood in emergency  situations. Shock. 2014 May;41 Suppl 1:70-5
  6. Strandenes G, De Pasquale M, Cap AP, Hervig TA, Kristoffersen EK, Hickey M,
    Cordova C, Berseus O, Eliassen HS, Fisher L, Williams S, Spinella PC. Emergency whole-blood use in the field: a simplified protocol for collection and transfusion. Shock. 2014 May;41 Suppl 1:76-83.
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EAST Traumacast logo Coagulopathy Trauma TEG - Podcast #24

A discussion regarding causes of coagulopathy in trauma and the use of TEG in its diagnosis and management.

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EAST Traumacast logo Trauma Exsanguination Protocols in Trauma - Podcast #5

A discussion regarding the evidentiary basis for trauma exsanguination protocols in trauma systems and how to go about writing and implementing them

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EAST Traumacast logo Thromboelastography (TEG) in Trauma Care - Podcast #6

An in-depth discussion regarding use of TEG to diagnose both hypo- and hyper-coagulable states following injury

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EAST Traumacast logo The CONTROL trial: Factor VIIa in Trauma - Podcast #4

A discussion of the CONTROL trial, it's design, findings, and ramifications regarding the role of Factor VIIa in trauma patients. 

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