A5047762080- Trauma and Emergency Care Studies
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Cardiac Arrest and Resuscitation
- Blood transfusion and management
- Disaster Response and Management
- Abdominal Trauma and Injuries
- Trauma Management and Diagnosis
- Blood donation and transfusion practices
- Airway Management and Intubation Techniques
- Veterinary Pharmacology and Anesthesia
- Emergency and Acute Care Studies
- Cardiac, Anesthesia and Surgical Outcomes
- Traumatic Brain Injury and Neurovascular Disturbances
- Thermal Regulation in Medicine
- Occupational Health and Performance
- Pleural and Pulmonary Diseases
- Climate Change and Health Impacts
- Treatment of Major Depression
- Pelvic and Acetabular Injuries
- Health and Conflict Studies
- Intensive Care Unit Cognitive Disorders
- Sepsis Diagnosis and Treatment
- Trigeminal Neuralgia and Treatments
- Nail Diseases and Treatments
- Hemostasis and retained surgical items
University of New Mexico
2020-2025
University of New Mexico Hospital
2021-2025
University of Colorado Denver
2021-2024
United States Army Medical Command
2019-2022
Uniformed Services University of the Health Sciences
2021-2022
Brooke Army Medical Center
2021-2022
United States Army Institute of Surgical Research
2017-2021
Bryan College
2017-2021
Madigan Army Medical Center
2021
Texas A&M University
2018-2021
Whole blood is the preferred product for resuscitation of severe traumatic hemorrhage. It contains all elements that are necessary oxygen delivery and hemostasis, in nearly physiologic ratios concentrations. Group O whole low titers anti-A anti-B antibodies (low titer group blood) can be safely transfused as a universal to patients unknown group, facilitating rapid treatment exsanguinating patients. stored under refrigeration up 35 days, during which it retains acceptable hemostatic...
Abstract Introduction The use of low titer O whole blood (LTOWB) has expanded although it remains unclear how many civilian trauma centers are using LTOWB. Methods We analyzed data on LTOWB recipients in the American College Surgeons Trauma Quality Improvement Program (TQIP) database 2020–2021. Unique facility keys were used to determine number that period. Results A total 16,603 patients received TQIP between 2020 and 2021; 6600 2020, 10,003 2021. facilities reported went from 287/779 (37%)...
TCCC has previously recommended interventions that can effectively prevent 4 of the top 5 causes prehospital preventable death in combat casualties-extremity hemorrhage, junctional airway obstruction, and tension pneumothorax- deaths from these have been markedly reduced US casualties. Noncompressible torso hemorrhage (NCTH) is last remaining major cause on battlefield often within 30 minutes wounding. Increased use whole blood, including capability for massive transfusion, if indicated,...
BACKGROUND Whole blood (WB) use has become increasingly common in trauma centers across the United States for both in-hospital and prehospital resuscitation. We hypothesize that WB (pWB) patients with suspected hemorrhage will result improved hemodynamic status reduced product requirements. METHODS The institutional registries of two academic level I were queried all from 2015–2019 who underwent transfusion upon arrival to bay. Patients dead on or had isolated head injuries excluded....
The use of tourniquets for life-threatening limb hemorrhage is standard care in military and civilian medicine. United States (U.S.) Department Defense (DoD) Committee on Tactical Combat Casualty Care (CoTCCC) guidelines, as part the Joint Trauma System, support application within a structured system reliant highly trained medics expeditious evacuation. Current practices by entities such DoD North Atlantic Treaty Organization (NATO) are supported evidence collected counter-insurgency...
Inflammation in acute cholecystitis may cause a cholecystectomy to be more challenging. Due the difficult dissection, conversion subtotal via laparoscopic or open procedure required. This is done reduce risk of bile duct injury and hemorrhage. We sought describe incidence factors, safety, morbidity, outcomes associated with bailout procedures.
INTRODUCTION In the far forward combat environment, use of whole blood is recommended for treatment hemorrhagic shock after injury. 2016, US military special operations teams began receiving low titer group O (LTOWB) at point injury (POI). This a case series initial 15 patients who received LTOWB on battlefield. METHODS Patients were identified in Department Defense Trauma Registry, and charts abstracted age, sex, nationality, mechanism injury, injuries physiologic criteria that triggered...
In planning for future contingencies, current problems often crowd out historical perspective and planners turn to technological solutions bridge gaps between desired outcomes the reality of recent experience. The US Military, North Atlantic Treaty Organization, other allies are collectively taking stock 10-plus years medical discovery rediscovery combat casualty care after wars in Iraq Afghanistan. There has been undeniable progress treatment wounded during course conflicts Southwest Asia,...
BACKGROUND Damage-control resuscitation has come full circle, with the use of whole blood and balanced components. Lack platelet availability may limit effective damage-control resuscitation. Platelets are typically stored transfused at room temperature have a short shelf-life, while cold-stored platelets (CSPs) advantage longer shelf-life. The US military introduced CSPs into battlefield surgical environment in 2016. This study is safety analysis for trauma. METHODS Department Defense...
QuikClot® Combat Gauze® (QCCG) was fielded in 2008 to replace previous generations of hemostatic products. To the best our knowledge, despite nearly a decade use, there are no published data on use among US combatant forces. We describe QCCG by ground forces Afghanistan and compare patients who received compared with remaining population database did not receive QCCG.Data were obtained from Prehospital Trauma Registry (PHTR). Joint System personnel linked Department Defense (DODTR) for...
The literature continues to provide strong support for the early use of tranexamic acid (TXA) in severely injured trauma patients. Questions persist, however, regarding optimal medical and tactical/logistical use, timing, dose this medication, both from published TXA TCCC user community. has been explored outside trauma, new dosing strategies have pursued, expansion retrospective data grown as well. These questions emphasize need a reexamination by CoTCCC. most significant updates Guidelines...
Background: Most potentially preventable deaths occur in the prehospital setting before reaching a military treatment facility with surgical capabilities. Thus, optimizing care we deliver combat represents ripe target for reducing mortality. We sought to analyze data within Department of Defense Trauma Registry (DODTR). Materials and methods: requested all encounters any activity (e.g., interventions, transportation, vital signs) documented DODTR from January 2007 March 2020 along...
Abstract Background The Role 2 setting represents the most far‐forward military treatment facility with limited surgical and holding capabilities. There are data to guide recommendations on blood product utilization at 2. We describe consumption of products in this setting. Study Design Methods analyzed from 2007 2023 Department Defense Trauma Registry (DODTR) that received care a used descriptive inferential statistics characterize volumes consumed also performed secondary analysis US...
The U.S. Military needs fast-acting, non-opioid solutions for battlefield pain. recently used morphine auto-injectors, which are now unavailable. Off-label ketamine and oral transmucosal fentanyl citrate use introduces challenges is therefore uncommon among conventional forces. Sublingual suftentanil the only recent pain medication acquired to fill this gap. Conversely, methoxyflurane delivered by a handheld inhaler promising, available some partner We describe reported in Department of...
INTRODUCTION Hemorrhage is a leading cause of death in pediatric patients. Accumulating data suggest that low-titer group O whole blood (LTOWB) improves clinical outcomes the population. We examined what ratio LTOWB to total product conferred survival benefit transfused trauma METHODS retrospectively cohort injured subjects younger than 18 years from Trauma Quality Improvement Program database who received any quantity and no documented prehospital cardiac arrest. created variable...
Abstract Introduction Data on the correlation between transfusion volumes and trauma mortality are limited. The association total number of red blood cell (RBC) low titer group O whole (LTOWB) units, as well volume all transfused products that were administered up to 4‐h after admission 24‐h was determined. Methods Trauma Quality Improvement Program (TQIP) datasets from 2020 2022 reviewed identify patients aged ≥15 who received any products. Receiver operating characteristic (ROC)...