Miscellaneous Trauma
DVT Prophylaxis in Trauma
The fellow should be able to:
- Demonstrate an understanding of the problem of DVT/VTE in trauma patients
- Demonstrate an understanding of the role of DVT prophylaxis in solid organ injuries
- Recognize the controversies and role of DVT prophylaxis in patients with TBI
- Describe different dosing strategies and medications used in DVT prophylaxis in trauma
- Understand the role of IVC filters in trauma patients
Resources
- Topic Summary
- Meet the Mentors - Post-Traumatic Pulmonary Emboli
- Additional Resources:
- Amanda L. Teichman, MD, FACS; Bryan A. Cotton, MD, MPH; et al. Approaches for optimizing venous thromboembolism prevention in injured patients: Findings from the consensus conference to implement optimal venous thromboembolism prophylaxis in trauma. J Trauma Acute Care Surg. 2023.
- Brian K. Yorkgitis, PA_C, DO, FACS; Allison E. Berndtson, MD, FACS; et al. American Association for the Surgery of Trauma/American College of Surgeons –Committee on Trauma Clinical Protocol for inpatient venous thromboembolism prophylaxis after trauma. J Trauma Acute Care Surg. 2022.
- Eric J. Ley, MD; Carlos V.R. Brown, MD; et al. Updated guidelines to reduce venous thromboembolism in trauma patients: A Western Trauma Association critical decisions algorithm. J Trauma Acute Care Surg.2020.
- O’Toole RV, Stein DM, O’Hara NN, et al. Aspirin or Low-Molecular-Weight Heparin for Thromboprophylaxis after a Fracture. 2023;388:203-13.
- Murphy PB, de Moya M, Karam B, et al. Optimal timing of venous thromboembolic chemoprophylaxis initiation following blunt solid organ injury: meta-analysis and systematic review. Eur J Trauma Emerg Surg. 2022;48(3):2039-2046.
- Yu-Tung Wu, MD; Chih-Ying Chien, MD; et al. Early venous thromboembolism prophylaxis in patients with trauma intracranial hemorrhage: Analysis of the prospective multicenter Consortium of Leaders in Traumatic Thromboembolism study. J Trauma Acute Care Surg. 2023.
- Asanthi M. Ratnasekera, DO, FACS; Daniel Kim, MD; et al. Early VTE prophylaxis in severe traumatic brain injury: A propensity score weighted EAST multicenter study. J Trauma Acute Care Surg. 2023.
- Lui A, Park C, Chryssikos T, et al. Safety and comparative efficacy of initiating low-molecular-weight-heparin within 24 hours of injury or surgery for venous thromboembolism prophylaxis in patients with spinal cord injury: a prospective TRACK-SCI registry study. Neurosurg Focus. 2023;55(4):E17.
- Arash Mahajerin, MD, MSCr; John K. Petty, MD; et al. Prophylaxis against venous thromboembolism in pediatric trauma: A practice management guideline from the Eastern Association for the Surgery of Trauma and the Pediatric Trauma Society. J Trauma Acute Care Surg. 2017.
Trauma System Administration and Injury Prevention
The fellow should be able to:
- Demonstrate an understanding of how trauma systems are classified
- Describe how trauma systems determine where to direct injured patients
- Demonstrate an understanding of the role of the trauma director and program manager
- Describe the role of ACS verification in trauma center designation
- Understand the role of trauma programs and injury prevention
- Understand the basics of precess and quality improvement in trauma
Resources
Disaster Response and Triage
The fellow should be able to:
- Demonstrate an understanding of the role of the hospital in the community’s response to a disaster or mass casualty
- Describe the phases of disaster response
- Demonstrate an understanding of the principles of triage in mass casualty events
- Recognize the ethical controversies associated with triage
Resources
Firearm Injury and Ballistics
The fellow should be able to:
- Demonstrate an understanding of the types of firearms and how they are classified
- Demonstrate an understanding of the differences between shotgun, rifle, and handgun injuries
- Describe the concept of cavitation and blast injury as it relates to tissue trauma
Resources
- Topic Summary
- Meet the Mentors - Firearm Injury Prevention
- Meet the Mentors - Firearm Injury Prevention
- Meet the Mentors - The Surgeon's Role in Firearm Injury
- Overview Article:
- Stefanopoulos PK, Hadjigeorgiou GF, Filippakis K, Gyftokostas D. Gunshot wounds: A review of ballistics related to penetrating trauma. Journal of Acute Disease 2014: 178-185
- Additional Resources:
- Dienstknecht T, Horst K, Sellei RM, Berner A, Nerlich M, Hardcastle TC. Indications for bullet removal: overview of the literature, and clinical practice guidelines for European trauma surgeons. Eur J Trauma Emerg Surg. 2012 Apr;38(2):89-93.
- Anisha Apte, MD; Kevin Bradford, MLS; et al. Lead toxicity from retained bullet fragments: A systematic review and meta-analysis. J Trauma Acute Care Surg. 2019.
- Simpson, Bonnie M. MD; Wilson, Robert H. MD; Grant, Richard E. MD. Antibiotic Therapy in Gunshot Wound Injuries. Clinical Orthopaedics and Related Research. 2003; 408: 82-85.
- Faber NA, Kathe NH, Myers RJ, Collins JN. Duration of Antibiotic Prophylaxis for Ballistic Fractures to the Extremities. Am Surg. 2023 Jul;89(7):3047-3051.
- Dehne LM, Foertsch MJ, Droege CA, Makley AT, Mosher DR, Philpott CD, Sagi HC, Mueller EW, Droege ME. Antibiotic Duration Following Abdominal Gunshot Injuries With Associated Pelvis or Spine Involvement: A 20-Year Single-Center Experience. J Surg Res. 2023;291:97-104.
- Schellenberg M, Inaba K, Heindel P, Forestiere MJ, Clark D, Matsushima K, Lam L, Demetriades D. The diagnostic dilemma of shotgun injuries. Eur J Trauma Emerg Surg. 2020 Dec;46(6):1351-1356.