show episodes
 
Medical education podcast dedicated to providing high-quality, concise, and clinically relevant multimedia content spanning the spectrum of surgical critical care, emergency general & trauma surgery
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Migraine Surgeon Dr. Adam Lowenstein hosts this podcast for chronic headache, migraine, and occipital neuralgia sufferers to learn about the diagnosis and treatment of these diseases. We will be discovering and discussing this information through interviews with experts in the field of headache and migraine treatment, and we will be answering questions submitted to our email at questions@headachesurgery.com. We will be discussing the diagnosis and treatment of all types of headache pain incl ...
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Follow our patient Courtney from the morning of her headache surgery in the pre-operative area through multiple explanations of her surgery in real time through to her postoperative visit the morning after her migraine surgery. This podcast is also available on our youtube channel at https://youtu.be/tv-YXQVvj9U or our website at HEADACHESURGERY.CO…
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Headache diagnoses often don't correspond to headache CAUSE and therefore can be confusing. The diagnosis that is given to a patient is often made on a subjective basis, encompassing features of the headache such as timing and associated symptoms. Dr. Lowenstein discusses the similarities in causes of headaches, which can often be successfully trea…
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In this episode we sit down with the Chief of Trauma, Surgical Critical Care, Burns, & Acute Care Surgery at the University of Arizona, Dr. Bellal Joseph, who share with us his thoughts and research findings on hot topics including frailty, geriatric trauma, leadership, and more. Timestamps: 00:12 Introductions 01:30 What is frailty? Your physiolog…
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In this episode, we talk all things critical care the one and only, Dr. Jean-Louis Vincent aka. JLV. This episode is a MUST listen. We touch upon the evolution of early goal directed therapy, measures of fluid responsiveness, optimizing oxygen delivery, and the importance of integrating data points versus examining them in isolation when caring for…
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In this episode, we discuss the overarching importance of AVOIDING iatrogenic harm in the ICU with arguably one of the world's leading experts in critical care medicine, the one and only, Dr. Jean-Louis Vincent aka. JLV. Tune in as Dr. Vincent shares with us the importance of having a systematic, problem-based approach to patient care delivery whic…
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Christa discusses her severe headaches following multiple head traumas and systemic diseases, as well as how her debilitating headache pain affected her life and the lives of her family. She also discusses her prolonged recovery from headache surgery (nerve decompression surgery) and her life during and after her recovery.…
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"Getting patients resuscitated through sepsis, septic shock, and hemorrhagic shock is not the end...it's the beginning." In this episode, Dr. Brakenridge from Harborview Medical Center joins us to discuss PICS and the impact of this syndrome on our critically ill and injured patients and their families. Also referred to as the Post-Intensive Care S…
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In this, our 50th episode, we are in Austin, TX, for the Annual EAST Scientific Meeting where we are joined by Dr. Bryan A. Cotton who shares his expertise and knowledge regarding the use of whole blood (WB) in trauma patients. From the use of whole blood in prior military conflicts to the design and successful implementation of one of the only pro…
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In the second episode of a two-part series, Dr. Mattox shares his insights and thoughts on hot research topics in trauma in need of investigation. Additionally, he helps us to envision what acute trauma management may look like in the future, while also sharing with us how his book (and one of my ALL-TIME fave surgery books!), Top Knife, came into …
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We. Are. Back!! After a (brief?!) hiatus, we are launching 2022 with a 2-part series with the one and only Dr. Ken Mattox. In this episode, Dr. Mattox shares with us his thoughts on what the modern general surgeon should look like and how we as surgeons differ from our medicine counterparts. Additionally, we review the history of modern trauma resu…
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Dr. Wes Ely from Vanderbilt University School of Medicine joins us on Rounds to discuss the evolution of our understanding and the current impact of ICU-acquired brain disease on our patients and their loved ones. In addition to discussing the evidence behind current best practices in the ICU, Dr. Ely shares with us stories from his new book which …
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In follow-up to a recent pro-con debate on the use of pre-hospital pelvic binders, we explore the why, when, and how of pelvic binder placement. From the indications to post-placement considerations and importance of a multidisciplinary approach to the management of these life-threatening injuries, this episode of Rounds is a great addition to Seas…
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In this episode, we sit down with Dr. Carlos VR Brown from the Dell Seton Medical Center at the University of Texas to discuss issues relevant to both junior and mid-career trauma & acute care surgeons. Topics covered include: military-civilian trauma, finding one's niche in academic surgery, work-life balance, and learning from our mistakes. As I …
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Massive upper GI bleeds can be intimidating and lethal. An expeditious, multidisciplinary approach is required to improve survival and optimize patient outcomes. Time Stamps: 00:12 Welcome & Introduction 01:55 Goals & Objectives 02:29 Common Etiologies & Differential Diagnosis for UGIBs 05:15 Initial Evaluation 10:52 Initial Management 15:38 Indica…
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Our first in-person interview since the start of the COVID pandemic! Join us for National Stop the Bleed Day as Dr. Kenji Inaba from LAC+USC joins us to discuss management of penetrating cardiac injuries, the Los Angeles County Hospital Emergency Response Team (HERT), and recent updates to the Stop the Bleed campaign. From the utility of FAST to th…
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Join us as we discuss surgical management options for the difficult gallbladder. Is it better to open or proceed with a laparoscopic subtotal cholecystectomy? If the latter, fenestrated or reconstituted? What's the difference?! This week on Rounds, we have several guest professors join us to discuss their perspectives and experience on managing pat…
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Bowel obstructions may be due to mechanical or functional causes. Although acute colonic pseudo-obstruction (ACPO) falls into the latter category, we must ALWAYS rule out mechanical causes for massive distension of the colon. In this episode, we make our way down the GI tract and discuss the pathophysiology, risk factors, diagnostic and therapeutic…
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Whether due to occlusive or nonocclusive obstruction of the arterial inflow or obstruction of venous outflow, acute mesenteric ischemia (AMI) continues to be associated with high mortality rate. Early recognition based on a high index of suspicion is critical to early diagnosis and intervention, particularly among patients presenting with pain out …
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Rare. Morbid. Lethal. NSTIs area group of infections which result in aggressive tissue destruction, systemic toxicity, and can involve any layer of the soft tissue. The key to successful management (like so many disease processes) is having a high index of suspicion together with administration of early, broad-spectrum antibiotics and surgery. Supp…
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Dr. Scott Weingart joins us on Rounds to discuss a topic that's of great interest to the both of us - surgical cricothyroidotomy. Tune in to hear how Scott's approach to performing a cric has evolved over time and why "trauma surgeons are the worst people to learn crics from?!" From 3 strikes and your out to the use of bougies, this episode covers …
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What are the determinants of mean airway pressure? Is too much PEEP ever a bad thing? In this episode, we review determinants of oxygenation in mechanically ventilated patients and discuss the benefits and risks of high versus low PEEP strategies, as well as the utility of lung volume recruitment maneuvers. Check out our previous related episodes 1…
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Back to the basics! In this episode we review the evolving criteria, etiologies, and pathophysiology of ARDS. A brief review of ventilator induced lung lung injury and initial vent setup provide the groundwork for future episodes exploring how to troubleshoot the vent and therapies for ARDS that have been shown to improve oxygenation and mortality.…
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Dr. Jamie Coleman from Denver Health joins us on Rounds to share her insights and knowledge surrounding wellness, sleep, and stress among surgeons and frontline workers. From healthy pre-call preparation and tips on healthy sleep hygiene to harnessing resilience and measuring the burden of unacknowledged mental health disorders on health care profe…
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Dr. Martin Zielinski from the Mayo Clinic, Rochester, MN, joins us on Rounds to discuss best practices in the management of bowel obstruction. In this episode, we review common etiologies for bowel obstruction, discuss the role of imaging, as well as the significance of clinical and radiographic findings on the likelihood of operative intervention.…
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In this follow-up episode to our discussion with Dr. Scott Weingart of EMCrit, we review the indications for performing a resuscitative thoracotomy, together with the potential application of a circulation first resuscitation strategy, and some intricacies regarding performing a surgical cricothyroidotomy. Support the show…
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Dr. Walt Biffl from Scripps Memorial Hospital La Jolla joins us on Rounds to discuss the evolution of BCVI management from the early 1990s to present day. Topics discussed include screening criteria, the diagnostic approach and imaging modalities for accurately identifying these injuries in our blunt polytrauma pateints. Grading criteria, antithrom…
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Who should be primarily responsible for managing vascular injuries? Trauma surgery? Vascular surgery? BOTH?! In this episode, we join the teams from the highly successful Behind the Knife and Audible Bleeding Podcasts to discuss the importance of a collaborative approach to the management of vascular trauma in an era marked by a decrease in general…
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Dr. Joel Topf joins us on Rounds to discuss and review key concepts in the recognition and management of acute kidney injury (AKI) in the SICU. AKI is a common and morbid complication among hospitalized patients. Further, trauma and surgical patients, in particular, are at an increased risk for AKI due to the myriad of pre-, intra-, and postrenal i…
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In recognition of Sepsis Awareness Month, Dr. Matt Martin joins us once again on Rounds to discuss state-of-the-art sepsis management in 2020. Also joining us on Rounds is Dr. Vanessa Ho from MetroHealth Medical Center in Cleveland, Ohio, who authored a recently published review paper in Surgical Infections earlier this year, "Sepsis 2019: What Sur…
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What are the 5 or 6 Ps? If you answered Pain, Pain, Pain, Pain, Pain, and Pain, you can go right ahead and skip this episode. Extremity compartment syndrome is an acute surgical emergency and requires a HIGH index of suspicion in order to make the diagnosis. Therapy consists of fasciotomy. If left untreated, numerous complications and sequelae may …
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Over the course of 30+ episodes, we'll be discussing fundamental surgical disease processes & conditions that may prove challenging to even the most seasoned acute care surgeon. Along the way, we'll be joined on Rounds by an incredible group of guest professors who will share their experiences, expertise, and results of recent research investigatio…
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So apparently not all of the listeners of the show are on Twitter?! In this brief recap of Season 1 (yes, Season 1 is done!) we pay thanks to all of our guest professors, provide you with an update of where we are in terms of the Season 2 launch, and, as usual, invite you to engage with me, the show, and our social media account. Support the show…
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Dr. Megan Brenner joins us on Rounds to discuss the evolving role of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in the management of trauma & acute care surgery patients with non-compressible torso hemorrhage. Advances in technology, evolving indications, and controversies regarding the appropriate and safe deployment of REBO…
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Dr. Clay Burlew from Denver Health joins us Rounds to discuss the management of trauma patients with hemodynamically unstable pelvic ring fractures. Topics covered during this episode include utility and technique of preperitoneal packing (PPP), evolution of the institutional multidisciplinary pathway for the management of unstable pelvic fractures…
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Knife. Finger. Tube. Sounds simple enough. And you read correctly....a bougie is both unnecessary and superfluous! In this episode I share you some tricks of the trade for performing a cric successfully, together with post-surgical airway considerations including hemorrhage control and the decision to convert to a formal tracheostomy. Support the s…
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In this episode we discuss endpoints of resuscitation with a focus on the pros and cons of both passive and dynamic hemodynamic measurements including arterial pressure waveform analysis, ultrasonography, and passive leg raising. Please visit www.traumaicurounds.com and check out the Vidcast for this episode. Support the show…
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Dr. Eric Simms joins us on Rounds to share with us his foolproof and fun way of remembering the dreaded coagulation cascade. Supplementing this podcast is a vidcast (https://www.traumaicurounds.ca/vidcasts) that provides us with a helpful visual explanation for understanding the key factors, steps, and intricacies of the coagulation cascade. Suppor…
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Dr. Eric Ley from Cedars-Sinai Medical Center joins us on Rounds to discuss the recently published Western Trauma Association's Critical Decisions Algorithm for reducing VTE in trauma patients. Early risk stratification, timing and initial dose of LMWH, weight-based dosing, and surveillance screening are just a few of the key topics we discuss on t…
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Dr. Martin Schreiber, Division Head of Trauma, Critical Care, and Acute Care Surgery at Oregon Health and Science University (OHSU) joins us on Rounds to discuss the results of his recently accepted prospective RCT of prehospital TXA use in adult patients with traumatic brain injury. In addition, we discuss the rise of hemostatic adjuncts, balanced…
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Determining whether or not your intubated and ventilated patient requires ongoing ventilatory support should not be overly complicated. In this episode we review the approach to determining if our mechanically ventilated patients can be safely extubated. In addition to discussing readiness for spontaneous breathing trial (SBT) criteria, we also dis…
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Which of your patients are at risk for developing intraabdominal hypertension (IAH) and the abdominal compartment syndrome (ACS)? In this episode, we review the classification, pathophysiology, and widespread systemic effects of this potentially fatal and, often times preventable, surgical disease process. We also discuss key diagnostic and therape…
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Dr. Sam Tisherman from the Shock Trauma Center joins us on Rounds to discuss his ongoing, cutting-edge research in EPR-CAT. Colloquially known as "suspended animation", EPR-CAT may provide trauma & acute care practitioners with the desperately needed time that's required to repair lethal exsanguinating injuries through the induction of profound hyp…
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Dr. Paula Ferrada joins us on Rounds this week to discuss several topics ranging from a circulation first approach in hemodynamically unstable trauma patients to the importance of inclusion, diversity, and equity in surgery & medicine. Clinical pearls, invaluable insight, and career advice for learners at different stages of their careers round out…
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Time is tissue. Early recognition of shock with immediate institution of lifesaving therapies are critical to successful patient outcomes. Establishment of functional IV access together with augmentation of cardiac output through increased preload and appropriate use of vasoactive agents are key aspects in the initial management of sick patients. S…
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To trach or not to trach? That is the question we're addressing in our first Rapid Rounds. One topic. Two to three questions. All in under 10 minutes. This week's rounds is informed by 2 recent articles in the trauma critical care literature published in Trauma Surgery Acute Care Open (TSACO) and the Journal of Trauma and Acute Care Surgery (JTACS)…
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Pressure. Packing. Tourniquet. In this episode, we provide a glimpse into the American College of Surgeons Stop the Bleed Program, from inception to present day. We also discuss the increasing use of tourniquets as an adjunct to hemorrhage control in patients with severe extremity injuries. Support the show…
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In this follow-up episode to Episode 3, we discuss and review the key factors (3 Ts) that define a mode of mechanical ventilation. In addition to the Targeted control variable (volume or pressure), the other key factors determining a mode include the Type of breath and Timing of breath delivery. In addition to discussing what defines a mode, we als…
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