Traumacast

A series of 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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Select Traumacasts now eligible for AMA PRA Category 1 Credit TM self-assessment credits toward Part 2 of the ABS MOC Program. Visit the EAST Education Center for details.

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*EP after the Traumacast number identifies enhanced podcasts that have bonus visual material in addition to the audio component. The enhanced podcasts are best viewed using the iTunes podcast browser on your laptop or phone, or using a video browser such as QuickTime or Windows Media Viewer.

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Podcasts Currently Available


A Randomized Trial of TEG versus Conventional Coagulation Tests to Guide Massive Transfusion in Bleeding Trauma Patients: Interview with Dr. Gene Moore - Podcast #62
08/19/2016

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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Whole Blood Transfusion: Everything Old is New Again - Podcast #60
07/25/2016

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.
  7. http://rdcr.org/wp-content/uploads/2015/06/2013-williams-blood-transfusion-on-cruise-ships.pdfhttp://rdcr.org/wp-content/uploads/2015/06/2013-williams-blood-transfusion-on-cruise-ships.pdf
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Coagulopathy Trauma TEG - Podcast #24
12/28/2012

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

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Trauma Exsanguination Protocols in Trauma - Podcast #5
09/15/2011

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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Thromboelastography (TEG) in Trauma Care - Podcast #6
09/15/2011

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

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The CONTROL trial: Factor VIIa in Trauma - Podcast #4
09/14/2011

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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*EP after the Traumacast number identifies enhanced podcasts that have bonus visual material in addition to the audio component. The enhanced podcasts are best viewed using the iTunes podcast browser on your laptop or phone, or using a video browser such as QuickTime or Windows Media Viewer.

Your Traumacast Moderators

David Morris, MD
Intermountain Medical Ctr, Salt Lake City, UT

Firas Madbak, MD
University of Florida, Jacksonville, FL

Matthew J. Martin, MD
Madigan Army Medical Center, Tacoma, WA

Carrie Valdez, MD
Covenant Healthcare, Saginaw, MI

Eastern Association for the Surgery of Trauma

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