A5021790615- Trauma and Emergency Care Studies
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Cardiac Arrest and Resuscitation
- Blood transfusion and management
- Abdominal Trauma and Injuries
- Disaster Response and Management
- Pelvic and Acetabular Injuries
- Trauma Management and Diagnosis
- Blood donation and transfusion practices
- Injury Epidemiology and Prevention
- Appendicitis Diagnosis and Management
- Traumatic Ocular and Foreign Body Injuries
- Traumatic Brain Injury and Neurovascular Disturbances
- Vascular Procedures and Complications
- Pleural and Pulmonary Diseases
- Abdominal Surgery and Complications
- Cardiac, Anesthesia and Surgical Outcomes
- Hernia repair and management
- Muscle and Compartmental Disorders
- Japanese History and Culture
- Emergency and Acute Care Studies
- Venous Thromboembolism Diagnosis and Management
- Bone fractures and treatments
- Gun Ownership and Violence Research
- Hemostasis and retained surgical items
The University of Texas Health Science Center at San Antonio
2016-2025
The University of Texas Health Science Center at Houston
2018-2025
The University of Texas Southwestern Medical Center
2024
The University of Texas at San Antonio
2007-2024
KHM-Museumsverband
2024
Minneapolis Institute of Arts
2024
University of South Florida
2021
University of British Columbia
2021
Urology San Antonio
2021
University Health System
2020
Patients with severe traumatic injuries often present coagulopathy and require massive transfusion. The risk of death from hemorrhagic shock increases in this population. To treat the trauma, some have suggested early, aggressive correction using a 1:1 ratio plasma to red blood cell (RBC) units.We performed retrospective chart review 246 patients at US Army combat support hospital, each who received transfusion (>/=10 units RBCs 24 hours). Three groups were constructed according RBC...
Background: While the use of vascular shunts as a damage control adjunct has been described in series from civilian institutions no contemporary military experience reported. The objective this study is to examine patterns and effectiveness temporary management wartime injury. Materials: From September 1, 2004 August 31, 2005, 2,473 combat injuries were treated at central echelon III surgical facility Iraq. Vascular entered into registry reviewed. Location was divided proximal distal, shunt...
The aim of this study was to identify a mortality benefit with the use whole blood (WB) as part resuscitation bleeding trauma patients.Blood component therapy (BCT) is current standard for resuscitating patients, WB emerging product choice. We hypothesized that versus BCT alone would result in decreased mortality.We performed 14-center, prospective observational patients who received during their resuscitation. applied generalized linear mixed-effects model random effect and controlled age,...
Medical lessons learned from Vietnam and previous military conflicts led to the development of civilian trauma systems in United States. Operation Iraqi Freedom represents first protracted, large-scale, armed conflict since advent which evaluate a similar paradigm on battlefield.Collaborative efforts between joint forces States initiated theater system May 2004. Formal implementation occurred November 2004, collaborative effort three Surgeons General U.S. military, Army Institute Surgical...
Wartime missile injuries are frequently high-energy wounds that devitalize and contaminate tissue, with high risk for infection wound complications. Debridement, irrigation, closure by secondary intention fundamental principles the management of these injuries. However, was impractical in Iraqi patients. Therefore, were closed definitively before discharge all patients treated such injures at our hospital. A novel protocol developed to facilitate this practice, patient outcomes tracked. This...
Incomplete or delayed fasciotomies are associated with muscle necrosis and death in civilian trauma. Combat explosions severely damage tissue distort normal anatomy making challenging. Rapid air evacuation may delay treatment of patients evolving extremity compartment syndrome. We investigated the impact fasciotomy revision release on combat casualties after evacuation.A retrospective review was performed who underwent Iraq, Afghanistan, at Landstuhl Regional Medical Center between January...
Background: Bleeding is a major cause of death in patients with traumatic injuries. Recently, thrombelastograph (TEG) has been suggested as an additional means evaluating coagulation trauma patients. We hypothesized that TEG data would aid defining the coagulopathy penetrating Methods: A retrospective study was performed (n = 44) injuries admitted to combat support hospital during 2-month period 2004. Recorded included standard laboratory data, parameters, and blood product use first 24...
BACKGROUND Although uncommon, Morel-Lavallée lesions (also called closed degloving injuries) are associated with considerable morbidity in trauma patients. There is lack of consensus regarding proper management these lesions. Management options include nonoperative therapies, along percutaneous and operative techniques. We sought to define the factors failure aspiration better identify patients requiring immediate management. METHODS retrospectively searched our prospectively collected...
The Trauma Hemostasis and Oxygenation Research Network held its third annual Remote Damage Control Resuscitation Symposium in June 2013 Bergen, Norway. is a multidisciplinary group of investigators with common interest improving outcomes safety patients severe traumatic injury. network's mission to reduce the risk morbidity mortality from hemorrhagic shock, prehospital phase resuscitation through research, education, training. concept remote damage control infancy, there significant amount...
Damage control resuscitation (DCR) is a strategy for resuscitating patients from hemorrhagic shock to rapidly restore homeostasis. Efforts are focused on blood product transfusion with whole or component therapy closely approximating blood, limited use of crystalloid avoid dilutional coagulopathy, hypotensive until bleeding achieved, empiric tranexamic acid, prevention acidosis and hypothermia, rapid definitive surgical bleeding. Patients receiving uncrossmatched Type O in the emergency...
To address the clinical and regulatory challenges of optimal primary endpoints for bleeding patients by developing consensus-based recommendations outcomes pivotal trials in within 6 categories significant bleeding, (1) traumatic injury, (2) intracranial hemorrhage, (3) cardiac surgery, (4) gastrointestinal (5) inherited disorders, (6) hypoproliferative thrombocytopenia.A standardized outcome evaluating hemostatic products strategies treatment clinically will facilitate conduct,...
The mortality from hemorrhage in trauma patients remains high. Early balanced resuscitation improves survival. These truths, with the availability of local resources and our goals for positive regional impact, were foundation development prehospital whole blood initiative-using low-titer cold-stored O RhD-positive blood. main concern use is potential isoimmunization RhD-negative patients. We used retrospective massive transfusion protocol (MTP) data to analyze anticipated risk this change...
BACKGROUND Despite countless advancements in trauma care a survivability gap still exists the prehospital setting. Military studies clearly identify hemorrhage as leading cause of potentially survivable death. Shifting resuscitation from hospital to point injury has shown great promise decreasing mortality among severely injured. MATERIALS AND METHODS Our regional network (Southwest Texas Regional Advisory Council) developed and implemented multiphased approach toward facilitating remote...
Abstract Background Low titer O+ whole blood (LTOWB) is being increasingly used for resuscitation of hemorrhagic shock in military and civilian settings. The objective this study was to identify the impact prehospital LTOWB on survival patients receiving transfusion. Study design methods A single institutional trauma registry queried undergoing transfusion between 2015 2019. Patients were stratified based (PHT) or no (NT). Outcomes measured included emergency department (ED), 6‐h hospital...
Mass casualty incidents and massive transfusion requirements continue to plague the USA with hemorrhage remaining number one cause of death in trauma. The unfortunate reality numerous mass shootings Southwest Texas has led need for a way which provide blood during these events as rapidly it is required. Multiple agencies within system have united help this life-saving people when they most. This effort began development safe, efficient, now widespread use whole region. After demonstrating...
Abstract Background Prehospital blood transfusion improves survival among patients in hemorrhagic shock but remains underutilized, part due to financial barriers. However, little is known about how prehospital programs are reimbursed. The objective of this study determine the percentage that receive reimbursement, receiving who were public health insurance‐eligible (pediatric and geriatric patients), most common reason for transfusions these populations. Study Design Methods An electronic...
Objective: Fresh whole blood (FWB) and red cells (RBCs) are transfused to injured casualties in combat support hospitals. We evaluated the risks of FWB RBCs combat-related casualties. Design: Retrospective chart review. Setting: Deployed U.S. Army Subjects: Donors recipients RBCs. Measurements Results: The storage age at transfusion was measured as an indicator overall risk associated with lesion between January 2004 December one hospital. Between April 2004, prescreened only hospital for...
Combat injury patterns differ from civilian trauma in that the former are largely explosion-related, comprising multiple mechanistic and fragment injuries high-kinetic-energy bullets. Further, unlike civilians, U.S. armed forces combatants usually heavily protected with helmets Kevlar body armor ceramic plate inserts. Searchable databases providing actionable, statistically valid knowledge of surface entry wounds resulting organ severity essential to understanding combat trauma.Two tools...