AAST's Cutting Edge Daily Newsletter
Tuesday September 19th
Click HERE to View the Cutting Edge Email
Editor’s Column
Written by: Shannon Marie Foster, MD, FACS
Welcome to Anaheim and the 82nd Annual Meeting of the American Association for the Surgery of Trauma! For those here in person – we are excited to see you and reconnect or start anew to learn about you and your needs as an active acute care surgeon/researcher/educator! For those reading remotely – we hope this daily newsletter brings to life the research, keynote presentations, and highlights of this important event. Note the format of each edition will highlight announcements and schedule and act as a precursor/taser to the podium speakers of the next day.
Today allowed pre conference focused education. Highlights include laparoscopic transcystic common bile duct exploration procedural skills training – as per Dr. Marc de Moya, the lead course faculty, “The skills needed to perform a transcystic common bile duct exploration are easy extensions of your skills removing an inflamed gallbladder and performing an intra-operative cholangiogram.” Expect more opportunities to participate in this underutilized skills enhancement.
Also popular was the Research Symposium with a full day of best practice and how-to training. Per Dr. Julia Coleman, course faculty, many of the important educational highlights are available via other avenues: “The findings of the National Trauma Research Action Plan…are available online and can serve as a compass for early scientific investigators looking for areas to be impactful. Techniques for writing a successful grant application and funding mechanisms relevant to the trauma and acute care surgeon…can be captured through participating in the grant writing mentorship program organized through the MIT committee. The two-day course...keynote address highlights the need to expand the current number of surgeon scientists…as published in multiple JTACS articles written by AAST members.”
The Presidential Address as per Dr. Eileen Bulger is a must. Dr. Tanya Anand has interviewed and summarized the career experiences and paths that led to the topic of We Are In This Together: The Power of Social Connection. More of this interview transcript and video footage will be available in future AAST Cutting Edge Editions.
Look for a new edition each evening!
Please keep commenting and sharing.
All feedback always welcome: shannonfostermd@gmail.com and erinlillisaast@gmail.com
Thank you for participating in the 82nd!!
SMF
Presidential Address: Interview of Dr. Eileen Bulger
Presidential Address, 'We Are in This Together': The Power of Social Connection'
Written by: Tanya Anand MD, MPH, MT(ASCP), FACS
The 82nd annual meeting of The AAST & Clinical Congress of Acute Care Surgery is upon us, and we could not be more excited! Dr. Eileen Bulger will be delivering the Presidential Address on Wednesday September 20th. Its title, “We Are in This Together: The Power of Social Connection” is meaningful and powerful and we are eagerly awaiting the lessons learned along the way.
I recently had the opportunity to sit down with Dr. Bulger, and better understand the inspiration for her talk. The importance of the human connection in her trek to becoming a leader in trauma was clear. She describes the lifetime of mentorship continuing to guide her career and allowing her to advance the care of trauma patients. From her early days as a paramedic to becoming the President of the AAST she attributes her success to the inspirational human element. An important example is the mentor-mentee relationship. She discussed the importance of early identification of mentors genuinely driven by their mentee’s success. The individuals in her life, whether it be her family, mentors, or colleagues, are vital sources of inspiration, support, and honest feedback during critical decision points in her life and career. These critical points, including her decision to train at the University of Washington and seeking institutional faculty to guide her research were just some of the areas that influenced her trajectory in trauma.
When discussing the importance of national meetings Dr. Bulger encourages everyone to get involved. There is early exposure to a wide breadth of trauma research, as well as numerous opportunities to develop a network of peers and collaborate. The bonds that form during these interactions contribute to scientific advancements and ultimately further the care of trauma patients. Navigation through these waters may be challenging for some, but very doable, and resulting in a high likelihood of success. Dr. Bulger wants to shorten the timeline from being the nervous trainee presenting at their first meeting, to being the person able to comfortably engage all members in the room. Creating that sense of community is of utmost importance.
She credits young trauma practitioners of pushing the envelope and thinking broadly to advance the profession. Though much work remains, the rise in young members and diversity has served to increase our awareness of topics concerning violence prevention, health equity, and social determinants of health. The younger AAST members have encouraged the profession to take a more holistic approach to trauma care and prioritize research on the post-discharge consequences of injury. Dr. Bulger foresees a more dominant role of ECMO in Trauma and Acute Care Surgery. Extending the breadth of ECMO training in fellowship will allow trainees to broaden their skillset and become comfortable in taking surgical rescue to the next level in trauma and ACS patients.
She cites that the pandemic was a great teacher as well. Social isolation combined with a stressed healthcare infrastructure contributed to a previously unseen level of burnout. The challenges experienced exposed unanticipated vulnerabilities in our system. Thus, how we manage the next surge and our ability to decrease preventable deaths depends on the improvements we make now. The creation of a National Trauma Emergency Preparedness System is amongst the many initiatives Dr. Bulger is developing in partnership with local, regional, and national entities to create a strong coordinated response that can withstand the next surge.
A key aspect of furthering initiatives in firearm injury prevention is shaping the national discussion as a vital matter for the public’s health. Dr. Bulger has played an instrumental role in defining and promoting the components of a public health approach towards firearm injury prevention. Investing in research to improve our understanding of the root causes of such violence is key in creating an informed and non-partisan approach to firearm safety. She stressed the importance of these programs and interventions at local, regional, and national levels. She has presided over several large multidisciplinary summits to identify knowledge gaps and improve collaboration amongst stakeholders.
Dr. Bulger understands that our awareness of our impact upon our patients, each other, and the community is an important driving force to improve the quality of life for others. She aims to continue building a diverse and inclusive environment that fosters meaningful engagement and collaboration at all levels of training and practice. Whether advancing our understanding of post-traumatic inflammation, increasing firearm safety awareness, facilitating the improvement of pre-hospital resources, or optimizing post-discharge recovery, Dr. Bulger has an uncanny ability to recognize multifaceted themes impacting the lives of trauma patients and bringing them to the forefront of the national psyche.
Presenter Highlights
Sushma Sagar, MS
All India Institute of Medical Sciences New Delhi, India
Title of Presentation: "Impact of Immediate Post Operative Prosthesis (IPOP) on balance and quality of life (QoL) in patients with below-knee amputations following trauma: A randomized controlled"
What are you most excited for at the annual meeting? I am attending this event for the first time that too with a podium presentation is very exciting. Being able to present my work at an international platform on a novel concept is a wonderful opportunity
What led you to this line of research? As a Trauma Surgeon working at level 1 trauma center of the country for last 18 years ,I have been attending close to 250 amputees post trauma per annum. To follow and provide good rehabilitation care I started a dedicated Amputation clinic about 10 years back. Delay in procuring prosthesis due to various reasons was one of the major cause for not returning to work in these patients. Hence this trial was conceptualized to provide in hospital immediate post operative prosthesis to make them comply for a definitive prosthesis early
Leslie H. Vuoncino, MD
University of California Davis Medical Center
Title of Presentation: "Using Microfluidic Shear to Assess Transfusion Requirements in Trauma Patients"
What did you find as a useful resource that helped you to complete this project? My mentors! Drs. Callcut, Robles, and Ross played huge roles in helping me be successful and make progress with this project. They provided so much guidance as to how to adjust testing protocols, which statistical tests to run, and spent hours and hours of editing manuscripts and presentations so I could be productive.
What obstacles did you face? I was by no means an experienced researcher when I began my research year after our third year of residency. I had helped on a few projects during medical school, and case reports during residency, but carrying out my own project came with a steep learning curve. Plus, this technology and analyzer are very new so that meant we had to establish our own protocols, normal ranges, and define what clinical information we were obtaining from the tests. There were many times we would run the statistical analysis, and realize we had performed incorrect calculations for the sample data results, or the analyzer wasn’t running the tests correctly, and have to redo the whole process over again. It was a series of “learning opportunities”, and I am still not an experienced researcher, but I’ve come a long way.
Abdul Hafiz Al Tannir, MD
Medical College of Wisconsin
Title of Presentation: "Implementation of the 300CC-Rule Safely Decreases Chest Tube Placement In Traumatic Hemothorax"
What obstacles did you face? The main obstacles we encountered throughout this study are the ones pertaining to a retrospective review. In several instances, we were unable to collect important data, including the reason for observation failure due to the limitations in extracting clinicians’ decision retrospectively. Moreover, it may not be common for trauma surgeons to quantify a HTX using the previously validated Mergo’s forumula; as such, the increase in observation and compliance rates might be attributed to the general consensus among surgeons at our institution to observesmall HTXs.
What are you most excited for at the annual meeting? As a post-doctoral research fellow in trauma and acute care surgery, this is my first time attending the American Association for the Surgery of Trauma Annual Meeting. I am ecstatic to be offered the opportunity to present my work as a full oral presentation. More importantly, I am looking forward to meeting up with well-renowned trauma surgeons and checking out groundbreaking clinical and translational research conducted at different institutions.
Amelia Maiga, MD, MPH
Vanderbilt University Medical Center
Title of Presentation: "Would You Rather: Quantifying Perceptions of Functional Status after Traumatic Brain Injury"
What led you to this line of research? In clinical trials and cohort studies of traumatic brain injury (TBI), we frequently use the GOSE scale to measure outcomes. However, actual TBI patient perceptions of GOSE functional outcomes after an injury are lacking. I think this a critical gap in TBI research and one that we sought to address with this project.
What are you most excited for at the annual meeting? I’m looking forward to connecting with friends and colleagues from around the country. Also – science, opportunities for collaboration, and taking my 13-year-old daughter to Disneyland for the first