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3. Barriers to Breastfeeding During Surgery Residency

Author

Golestani, Simin, Cardenas, Tatiana, Koepp, Katherine, Efird, Jessica, Teixeira, Pedro G., Mery, Marissa, Dubose, Joseph, Trust, Marc D., Bach, Michelle, Ali, Sadia, and Brown, Carlos V.R.

Abstract

•Surgery residents reported a lack of space, resources, and dedicated time for pumping.•67% of survey respondents stated that they did not have adequate time for pumping.•2/3 of breastfeeding mothers reported a reduction in milk supply after return to work.•These challenges contribute to shorter breastfeeding duration.•It is crucial to provide well equipped lactation rooms and to foster a supportive culture.

Published
2024
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5. Pediatric emergency resuscitative thoracotomy: A Western Trauma Association, Pediatric Trauma Society, and Eastern Association for the Surgery of Trauma collaborative critical decisions algorithm.

Author

Martin, Matthew J., Brasel, Karen J., Brown, Carlos V. R., Hartwell, Jennifer L., de Moya, Marc, Inaba, Kenji, Ley, Eric J., Moore, Ernest E., Peck, Kimberly A., Rizzo, Anne G., Rosen, Nelson G., Weinberg, Jordan A., Coimbra, Raul, Crandall, Marie, Mukherjee, Kaushik, Ignacio, Romeo, Longshore, Shannon, Flynn-O'Brien, Katherine T., Ng, Grace, and Selesner, Leigh

Published
2023
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10. Blunt pancreatic trauma: A Western Trauma Association critical decisions algorithm

Author

Moren, Alexis M., Biffl, Walter L., Ball, Chad G., de Moya, Marc, Brasel, Karen J., Brown, Carlos V.R., Hartwell, Jennifer L., Inaba, Kenji, Ley, Eric J., Moore, Ernest E., Peck, Kimberly A., Rizzo, Anne G., Rosen, Nelson G., Sperry, Jason L., Weinberg, Jordan A., Coimbra, Raul, Shatz, David V., and Martin, Matthew J.

Abstract

The algorithm addresses the workup, diagnosis, and treatment of blunt pancreatic injury. A high degree of clinical suspicion for injury is often necessary. Recommendations include non-operative management for low-grade and operative management for high-grade injuries.

Published
2023
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11. Blunt splenic injury, Emergency Department to discharge: A Western Trauma Association critical decisions algorithm

Author

Shatz, David V., de Moya, Marc, Brasel, Karen J., Brown, Carlos V.R., Hartwell, Jennifer L., Inaba, Kenji, Ley, Eric J., Moore, Ernest E., Peck, Kimberly A., Rizzo, Anne G., Rosen, Nelson G., Sperry, Jason L., Weinberg, Jordan A., Moren, Alexis M., Coimbra, Raul, and Martin, Matthew J.

Abstract

This document outlines both management of these patients in the emergency and operating rooms, and provides guidance for the subsequent days and weeks following injury for those undergoing nonoperative treatment (observation or splenic angioembolization).

Published
2023
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13. Blunt thoracic aortic injury: A Western Trauma Association critical decisions algorithm

Author

Brown, Carlos V.R., de Moya, Marc, Brasel, Karen J., Hartwell, Jennifer L., Inaba, Kenji, Ley, Eric J., Moore, Ernest E., Peck, Kimberly A., Rizzo, Anne G., Rosen, Nelson G., Sperry, Jason L., Weinberg, Jordan A., Moren, Alexis M., DuBose, Joseph J., Coimbra, Raul, and Martin, Matthew J.

Abstract

This is a recommended evaluation and management algorithm from the Western Trauma Association Algorithms Committee addressing the management of adult patients with Blunt Thoracic Aortic Injury.

Published
2023
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14. EQIP's First Year: A Step Closer to Higher Quality in Surgical Education

Author

Joshi, Amit R.T., Nfonsam, Valentine, Relles, Daniel M., Murphy, Shawn, Ciolkosz, John, Fise, Tom, Klingensmith, Mary E., Hickey, Mark, Brunsvold, Melissa E., Korndorffer, James R., Jarman, Benjamin T., Smink, Douglas S., Terhune, Kyla, Kmiec, Kathryn, Harrington, David T., Edhayan, Elango, DiSiena, Michael, Kent, Tara, Rubino, Matthew, Prabhu, Ajita, Rosenkranz, Kari, Brown, Carlos, Edelman, David, Srinivasan, Jahnavi, Cagir, Burt, Surick, Burton, Neville, Angela, Choi, Jennifer N., Yeung, Louise, Cassaro, Sebastiano, Iverson, Kyle, Nepomnayshy, Dmitry, Namm, Jukes, Dorion, Heath, Truitt, Michael, Hope, William, Berman, Russell, Harzman, Alan, Kothuru, Ravi, Feinman, Marcie, Hoey, Brian, Dresner, Lisa, Williams, Mark, Chojnacki, Karen, Schroll, Rebecca, Nehler, Mark, Sarosi, George, Porter, Michael, Kavic, Stephen, LaFemina, Jennifer, Lees, Jason, Kempenich, Jason, Daley, Brian, Bailey, Christina, Chang, Lily, Hildreth, Amy, Borgstrom, David, Tuttle, Rebecca M., Mpinga, Ebondo, Rivera, Nancy, Hai, Shaikh, Zera, Richard, Halverson, Amy, Schurr, Michael, Bradley, Matthew, Sirsi, Sandeep, Fuhrman, George, Brasel, Karen, Palesty, Alexander, Nehler, Mark R., Crandall Crandall, Marie, Thambi-Pillai, Thav, and O'Rourke, Ann P.

Abstract

•EQIP is an innovative quality improvement project for surgical training programs.•Thirty-six surgical training programs with 1264 trainees and 1500 faculty members were included in the dataset.•The APDS has proved the concept that a highly secure database for the purpose of continuous risk-adjusted quality improvement in surgical education can be successfully deployed.•Risk-adjusted multivariable analysis suggests that increased time in a technical skills lab was associated with increased success on the ABS's Qualifying Examination, alone.•Increased time in a technical skills lab and the presence of a formal teaching curriculum were associated with increased success on both the ABS's Qualifying and Certifying Examination.•Program type may be of some consequence in predicting success on the Qualifying Examination.

Published
2022
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15. DEI-03 PERSISTENT EFFECTS OF HISTORICAL REDLINING ON TRAUMATIC UROLOGIC INJURIES: A GEOSPATIAL ANALYSIS IN A SOUTHERN US CITY.

Author

Eldin, Maya Malak, Bradford, James, Woodle, Tarah, Ancha, Niru, Gereta, Sofia, Butler, Imani, Khanna, Prachi, Mery, Marissa, Robert, Michelle, Ali, Sadia, Salvo, Deborah, Brown, Carlos V., and Laviana, Aaron

Subjects
GEOGRAPHIC information systems, WOUNDS & injuries, LOCATION data, RESIDENTIAL segregation, GEOSPATIAL data
Published
2024
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22. Chest and Pelvis X-Rays as a Screening Tool for Abdominal Injury in Geriatric Blunt Trauma Patients

Author

Leede, Emily, Cardenas, Tatiana C. P., Emigh, Brent J., Brown, Lawrence H., Teixeira, Pedro G., Trust, Marc D., Coopwood, Ben, Aydelotte, Jayson, Ali, Sadia, and Brown, Carlos V. R.

Abstract

Background This study evaluates the utility of chest (CXR) and pelvis (PXR) X-ray, as adjuncts to the primary survey, in screening geriatric blunt trauma (GBT) patients for abdominal injury or need for laparotomy.Methods We performed a retrospective analysis of patients 65-89 years in the 2014 National Trauma Data Bank. X-ray injuries were identified by ICD9 codes and defined as any injury felt to be readily detectable by a non-radiologist. X-ray findings were dichotomized as “both negative” (no injury presumptively apparent on CXR or PXR) or “either positive” (any injury presumptively apparent on CXR or PXR). Rates of abdominal injuries and laparotomy were compared and used to calculate sensitivity and specificity. The primary outcomes were abdominal injury and laparotomy. The secondary outcomes included mortality, ventilator days, and hospital days.Results A total of 202 553 patients met criteria. Overall, 9% of patients with either positive X-rays had abdominal injury and 2% laparotomy vs. 1.1% and .3% with both negative (P< .001). The specificity for any positive X-ray was 79% for abdominal injury and 78% for laparotomy. The sensitivity was 69% for abdominal injury and laparotomy. The either positive group had fewer ventilator days (.3 vs. .8, P< .0001), longer length of stay (7 vs. 5, P< .0001), and higher mortality (6% vs. 4%, P< .0001) vs both negative.Conclusion CXR and PXR can be used to assess for intra-abdominal injury and need for laparotomy. GBT patients with either positive X-rays should continue workup regardless of mechanism due to the high specificity of this tool for abdominal injury and need for laparotomy.

Published
2022
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23. A Western Trauma Association critical decisions algorithm: Resuscitative endovascular balloon occlusion of the aorta

Author

Inaba, Kenji, Alam, Hasan B., Brasel, Karen J., Brenner, Megan, Brown, Carlos V.R., Ciesla, David J., de Moya, Marc A., DuBose, Joseph J., Moore, Ernest E., Moore, Laura J., Sava, Jack A., Vercruysse, Gary A., and Martin, Matthew J.

Abstract

A Western Trauma Association Critical Decisions Algorithm: REBOA, providing a practical approach to the use of REBOA in trauma, based on the existing scientific evidence, expert opinion and the input of the Western Trauma Association membership. @WesternTrauma #REBOA

Published
2022
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24. A multicenter investigation of the hemodynamic effects of induction agents for trauma rapid sequence intubation.

Author

Leede, Emily, Kempema, James, Wilson, Chad, Rios Tovar, Alejandro J., Cook, Alan, Fox, Erin, Regner, Justin, Richmond, Robyn, Carrick, Matt, Brown, Carlos V.R., Texas Trauma Study Group (Frank Buchanan, MBA, Andrew Kolodziej, BS,LaDonna Allen, RN, Victoria E Herrick, Natalie Tully, MD), and Texas Trauma Study Group (Frank Buchanan, MBA, Andrew Kolodziej, LaDonna Allen, RN, Victoria E. Herrick, Natalie Tully, MD)

Published
2021
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28. Child physical abuse trauma evaluation and management: A Western Trauma Association and Pediatric Trauma Society critical decisions algorithm.

Author

Rosen, Nelson G., Escobar, Mauricio A., Brown, Carlos V., Moore, Ernest E., Sava, Jack A., Peck, Kimberly, Ciesla, David J., Sperry, Jason L., Rizzo, Anne G., Ley, Eric J., Brasel, Karen J., Kozar, Rosemary, Inaba, Kenji, Hoffman-Rosenfeld, Jamie L., Notrica, David M., Sayrs, Lois W., Nickoles, Todd, Letton, Robert W., Falcone, Richard A., and Mitchell, Ian C.

Published
2021
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32. A Prospective Study of Family Satisfaction Changes After Tracheostomy Placement in Trauma Patients

Author

Trust, Marc D., Lara, Sabino, Hecht, Jonathan, Teixeira, Pedro G., Coopwood, Ben, Aydelotte, Jayson, Cardenas, Tatiana C. P., Guerra, Erin, Ali, Sadia, and Brown, Carlos V. R.

Abstract

Background Tracheostomy is a commonly performed procedure in surgical intensive care units. Although the indications and benefits of this procedure are well known, little has been studied in the adult surgical/trauma population about patient family satisfaction after tracheostomy placement.Materials and Methods We performed a prospective study at our academic level I trauma center from 2015-2016 in patients who underwent elective tracheostomy. Family members were asked to complete an eight-point questionnaire using a forced Likert scale of graded responses. Questionnaires were administered prior to tracheostomy and again at 24-and 72-hour post-tracheostomy placement. Responses were compared using univariate analysis.Results A total of 26 family members completed all 3 surveys. Family members believed loved ones appeared more comfortable, were more interactive, and were better progressing clinically. After 72 hours, family members felt less anxiety. There was no difference in perceptions of patient distress, ability to provide support, or their worry about scars, or comfort in visiting them.Discussion Family members believed tracheostomies provided greater patient comfort, increased interactive abilities, better progress in their care, and experienced less anxiety after placement. Family satisfaction may therefore be an additional benefit in support of earlier tracheostomy.

Published
2021
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33. Into the wild and on to the table: A Western Trauma Association multicenter analysis and comparison of wilderness falls in rock climbers and nonclimbers.

Author

Bernard, Matthew, Martin, Matthew J., Corsa, Josh, Robinson, Bryce, Zeeshan, Muhammad, Joseph, Bellal, Morris, David, Shillinglaw, William, Schurr, Michael, Smith, Terrie, Lara, Sabino, Brown, Carlos, Harrell, Kevin, Maxwell, Robert, Berndtson, Allison E., Curry, Terry, Kaups, Krista, Dirks, Rachel, Rott, Michael, and Schroeppel, Thomas

Published
2020
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35. Concomitant bladder and rectal injuries: Results from the American Association for the Surgery of Trauma Multicenter Rectal Injury Study Group.

Author

Osterberg, E. Charles, Veith, Jacob, Brown, Carlos V. R., Sharpe, John P., Musonza, Tashinga, Holcomb, John B., Bui, Eric, Bruns, Brandon, Hopper, H. Andrew, Truitt, Michael, Burlew, Clay Cothren, Schellenberg, Morgan, Sava, Jack, Van Horn, Jon, and AAST Contemporary Management of Rectal Injuries Study Group

Published
2020
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41. Postoperative Complications in Emergent vs Non-emergent Thoracic Endovascular Aortic Repair in Blunt Thoracic Aortic Injuries From the Aortic Trauma Foundation Global Registry.

Author

Bach, Michelle S., DuBose, Joseph J., Efird, Jessica L., Ferrer Cardona, Lucas M., Ali, Sadia, Golestani, Simin, Crapps, Joshua, Du, Bonnie, Bradford, James, Brown, Carlos V.R., Aydelotte, Jayson, Cardenas, Tatiana, Trust, Marc, Robert, Michelle, and Teixeira, Pedro G.R.

Published
2023
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45. Acute Alcohol Use, History of Homelessness, and Intent of Injury Among a Sample of Adult Emergency Department Patients.

Author

Jetelina, Katelyn K., Reingle Gonzalez, Jennifer M., Brown, Carlos V. R., Foreman, Michael L., Field, Craig, K Jetelina, Katelyn, M Reingle Gonzalez, Jennifer, V R Brown, Carlos, and L Foreman, Michael

Subjects
COMPARATIVE studies, ALCOHOL drinking, EMERGENCY medical services, HOMELESS persons, LONGITUDINAL method, RESEARCH methodology, MEDICAL cooperation, RESEARCH, SELF-injurious behavior, EVALUATION research
Abstract

Background: The literature is clear that adults who are currently homeless also have higher rates of intentional injuries, such as assault and suicide attempts. No study has assessed whether intentional injuries are exacerbated because of substance use among adults with a history of homelessness.Methods: Data were obtained from a cohort of adults admitted to 3 urban emergency departments (EDs) in Texas from 2007 to 2010 (N = 596). Logistic regression analyses were used to determine whether a history of homelessness was associated with alcohol use at time of injury in intentional violent injuries (gunshot, stabbing, or injury consistent with assault).Results: 39% adults with a history of homelessness who were treated at trauma centers for a violent injury. Bivariate analyses indicated that adults who had ever experienced homelessness have 1.67 increased odds, 95% confidence interval (CI) [1.11, 2.50], of any intentional violent injury and 1.95 increased odds (95% CI [1.12, 3.40]) of a stabbing injury than adults with no history of homelessness.Conclusions: Adults who experienced homelessness in their lifetime were more likely to visit EDs for violencerelated injuries. Given our limited knowledge of the injuries that prompt ED use by currently homeless populations, future studies are needed to understand the etiology of injuries, and substance-related injuries specifically, among adults with a history of homelessness. [ABSTRACT FROM AUTHOR]

Published
2017
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46. Into the wild and on to the table: A Western Trauma Association multicenter analysis and comparison of wilderness falls in rock climbers and nonclimbers

Author

Bernard, Matthew, Martin, Matthew J., Corsa, Josh, Robinson, Bryce, Zeeshan, Muhammad, Joseph, Bellal, Morris, David, Shillinglaw, William, Schurr, Michael, Smith, Terrie, Lara, Sabino, Brown, Carlos, Harrell, Kevin, Maxwell, Robert, Berndtson, Allison E., Curry, Terry, Kaups, Krista, Dirks, Rachel, Rott, Michael, Schroeppel, Thomas, Stillman, Zachery, Warriner, Zachary, Inaba, Kenji, Burlew, Clay, Robinson, Caitlin, Jackson, Rebecca, Dunn, Julie, Chapin, Trinette, Wilson, Alison, Moulton, Steve, Phillips, Ryan, Shahi, Niti, Urban, Shane, Velopulos, Catherine, Davenport, Daniel, and C. Bernard, Andrew

Published
2020
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50. Rib Fractures and Mortality: Breaking the Causal Relationship

Author

Bankhead-Kendall, Brittany, Radpour, Sepeadeh, Luftman, Kevin, Guerra, Erin, Ali, Sadia, Getto, Christopher, and Brown, Carlos V.R.

Abstract

Rib fractures have long been considered as a major contributor to mortality in the blunt trauma patient. We hypothesized that rib fractures can be an excellent predictor of mortality, but rarely contribute to cause death. We performed a retrospective study (2008–2015) of blunt trauma patients admitted to our urban, Level I trauma center with one or more rib fractures. Medical records were reviewed in detail. Rib fracture deaths were those from any respiratory sequelae or hemorrhage from rib fractures. There were 4413 blunt trauma patients who sustained one or more rib fractures and 295 (6.8%) died. Rib fracture patients who died had a mean Injury Severity Score = 38 and chest Abbreviated Injury Score = 3.4. Rib fractures were the cause of death in only 21 patients (0.5%). After excluding patients who were dead on arrival, patients dying as a result of their rib fractures were found to be older (P< 0.0001) and had a higher admission respiratory rate (P= 0.02). Multivariable logistic regression found that age =65 was the only variable independently associated with mortality directly related to rib fractures (odds ratio 4.1, 95% confidence interval = 1.3–13.3, P value < .0001). Mortality in patients with rib fractures is uncommon (7%), and mortality directly related to rib fractures is rare (0.5%). Older patients are four times more likely to die as a direct result of rib fractures and may require additional resources to avoid mortality.

Published
2019
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