A5026538827- Trauma and Emergency Care Studies
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Cardiac Arrest and Resuscitation
- Abdominal Trauma and Injuries
- Cardiac, Anesthesia and Surgical Outcomes
- Traumatic Brain Injury and Neurovascular Disturbances
- Autopsy Techniques and Outcomes
- Mechanical Circulatory Support Devices
- Diversity and Career in Medicine
- Trauma Management and Diagnosis
- COVID-19 and healthcare impacts
- Thermal Regulation in Medicine
- Venous Thromboembolism Diagnosis and Management
- Abdominal Surgery and Complications
- Infrared Thermography in Medicine
- Blood transfusion and management
- Infection Control and Ventilation
- Disaster Response and Management
- Vascular Procedures and Complications
- Emergency and Acute Care Studies
- CRISPR and Genetic Engineering
- Meta-analysis and systematic reviews
- Advances in Oncology and Radiotherapy
- Injury Epidemiology and Prevention
- Medical Malpractice and Liability Issues
University of Alabama at Birmingham
2023-2025
University of North Carolina at Chapel Hill
2021-2025
Madigan Army Medical Center
2019-2024
United States Army
2024
University of Alabama at Birmingham Hospital
2023-2024
Birmingham VA Medical Center
2023
University of Puerto Rico at Carolina
2021
Mary Bridge Children's Health Center
2021
Scripps Mercy Hospital
2021
U.S. Army Combat Capabilities Development Command Chemical Biological Center
2020
Death after injury is a worldwide epidemic. Hemorrhage as cause of death represents the leading potentially preventable condition. Based on hard-won experience from recent wars, and two decades military civilian research, damage-control resuscitation (DCR) now widely used. This article will briefly describe history blood transfusion, outline "why we do DCR," then discuss "how DCR." Modern DCR occurs both prehospital in hospital has several main tenants. Currently, focuses liberal use...
Importance Frequentist statistical approaches are the most common strategies for clinical trial design; however, bayesian design may provide a more optimal study technique trauma-related studies. Objective To describe outcomes of using data from Pragmatic Randomized Optimal Platelet and Plasma Ratios (PROPPR) Trial. Design, Setting, Participants This quality improvement performed post hoc analysis PROPPR Trial multiple hierarchical models to assess association resuscitation strategy with...
Whole blood (WB) transfusion represents a promising resuscitation strategy for trauma patients. However, paucity of data surrounding the optimal incorporation WB into strategies persists. We hypothesized that traumatically injured patients who received greater proportion compared with product components during their resuscitative efforts would have improved early mortality outcomes and decreased requirements those components.
Prehospital blood transfusions result in a significant reduction mortality risk for injured patients hemorrhagic shock; however, prehospital have not been widely implemented across the United States. Thus, paucity of data surrounding impact achieving near-complete population-level access to this resource exists. We aimed determine number lives that could potentially saved among shock between 2020 and 2023 had products (blood components or whole blood, pBP) fully implemented. performed...
Introduction Graduate Medical Education plays a critical role in training the next generation of military physicians, ensuring they are ready to uphold dual professional requirements inherent being both officer and physician. This involves executing operational duties as commissioned leader while also providing exceptional medical care austere environments harm’s way. The purpose this study is review prior efforts at developing implementing unique curricula (MUC) residency programs. Methods...
Introduction Medical readiness is of paramount concern for active-duty military providers. Low volumes complex trauma in treatment facilities has driven the armed forces to embed surgeons high-volume civilian centers maintain clinical readiness. It unclear what impact this strategy may have on patient outcomes these centers. We sought compare emergent laparotomy (ETL) between Air Force Special Operations Surgical Team (SOST) general and faculty at an American College Surgeons verified level...
Traumatic injury leading to arterial damage has traditionally been repaired using autologous vein graft from the contralateral limb. This often requires a secondary surgical site and potential of prolonged operative time for patients. We sought assess use ipsilateral vs grafts in patients who experienced traumatic extremity vascular injury. A multicenter database was queried identify injuries requiring intervention with grafting. The primary outcome interest need reintervention. Secondary...
Shock index and its pediatric adjusted derivative (pediatric age-adjusted shock [SIPA]) have demonstrated utility as prospective predictors of mortality in adult trauma populations. Although basic vital signs provide promise triage tools, factors such neurologic status on arrival profound implications for trauma-related outcomes. Recently, the reverse multiplied by Glasgow Coma Scale (GCS) score (rSIG) has been validated a tool combining early markers physiology function to predict...
Shock Index Pediatric-Adjusted (SIPA) has been used to predict injury severity and outcomes after civilian pediatric trauma. We hypothesize that SIPA can the need for blood transfusion emergent surgery among patients injured in warzones, where resources are limited accurate triage is essential.Retrospective review of DoD Trauma Registry all 17 years or younger, from 2008 2015. was determined using vital signs recorded upon arrival initial level care. Patients were classified into two groups...
BACKGROUND Whole blood (WB) transfusions in trauma represent an increasingly utilized resuscitation strategy patients. Previous reports suggest a probable mortality benefit with incorporating WB into massive transfusion protocols. However, questions surrounding optimal practices persist. We sought to assess the association between proportion of transfused during initial resuscitative period and its impact on early outcomes for traumatically injured METHODS performed retrospective analysis...
The association between hypothermia, coagulopathy, and acidosis in trauma is well described. Hypothermia mitigation starts the prehospital setting; however, it often a secondary focus after other life-saving interventions. deployed environment further compounds problem due to prolonged evacuation times rotary wing aircraft, resource limitations, competing priorities. This analysis evaluates hypothermia combat casualties relationship resuscitation strategy with blood products.
Veno-venous extracorporeal membrane oxygenation (VV ECMO) improves hypoxemia and carbon dioxide clearance in patients with severe respiratory derangements. A greater understanding of the potential benefits VV ECMO trauma could lead to broader adoption. We hypothesize that who receive have improved mortality outcomes when compared those receiving conventional ventilator management given rapid stabilization promotes.
BACKGROUND Traumatic hemorrhage and coagulopathy represent major sources of morbidity mortality on the modern battlefield. Viscoelastic testing (VET) offers a potentially more personalized approach to resuscitation. We sought evaluate outcomes combat trauma patients who received VET-guided resuscitation compared with standard balanced blood product METHODS Retrospective analysis Department Defense Trauma Registry, 2008 2016 was performed. Multivariate logistic regression analyses all adult...