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Complex Trauma Case Study
Release and Expiration Dates
Released: 11.14.2021
Expires:    11.13.2024
Last Reviewed Date
Complex Trauma Case Study

Complex Trauma Case Study is a TCAA course created from a webinar during which Dr. Mains reviews a complex trauma case and the literature, to inform critical decisions related to hemorrhage control, transport, and damange control resuscitation. 

Estimated completion time:
60 minutes
Target Audience: The trauma healthcare team and other clinical departments

Learning Objectives:
At the conclusion of this course, the learner should be better able to:
1. Demonstrate decision making in complex case studies 

2. Interpret literature and apply to case scenarios 
3. Discuss modalities of treatment from PreHospital to Hospital care 

Faculty Presenter: Dr. Charles Mains

Faculty Bio:

Dr. Mains is currently the Trauma Medical Director for Centura Health Trauma System which includes 18 designated trauma centers in Colorado. Additionally, he provides trauma program consultation for 18 additional rural centers caring for trauma patients across Colorado & Kansas. He served as the Trauma Medical Director at St. Anthony Hospital, a Level I trauma center, for sixteen years and served as a member of the medical staff for almost twenty years, most recently as the Vice President of Medical Staff. Dr. Mains graduated from Duke University Medical School and received his post graduate education at the University of Colorado Surgical Residency Program. He is a fellow of the American College of Surgeons, a member of the Western Trauma Association, American Association for the Surgery of Trauma and The Society of Critical Care Medicine. In addition, he has authored numerous peer reviewed publications and speaks both nationally & internationally on a variety trauma related topics. Dr. Mains is actively involved in the State trauma system, currently serving as a governor appointed member of State Emergency Medical and Trauma Services Advisory Council, Chairman of the State Trauma Advisory Council and Chairman of Mile High Regional Emergency Medicine and Trauma Advisory Council. Dr. Mains is committed to trauma education across the state and frequently provides trauma lectures at facilities, EMS departments, and ski patrols. He is a course director for the Advanced Trauma Life Support course, Rural Trauma Team Development course (both through the American College of Surgeons) and an instructor for Fundamentals of Critical Care Support (supported by the Society of Critical Care Medicine).

Peer Reviewer
Bethlehem Emmons-Post
Oreste M Romeo
Jideofor Aniukwu
Armand, R., Hess, JR. Treating coagulopathy in trauma patients. Transfus Med Rev. 2003; 17(3): 223-231

Bickell, W., Wall, M., Pepe, P., Martin, R., Ginger, V., Allen, M., and Mattox, K. Immediate versus Delayed Fluid Resuscitation for Hypotensive Patients with Penetrating Torso Injuries. New England J Med 1994; 331:1105-9

Black, J., Abraham, P., Abraham, M., Cox, D., Griffin, R., Holcomb, J., Hu, P., Kerby, J., Liptrap, E., Thaci, B., Harrigan, M., and Jansen, J. Universal screening for blunt cerebrovascular injury. J of Trauma and Acute Care Surgery. 90(2):224-231, February 2021.

Chen, X., Gestring, M., Rosengart, M., Billiar, T., Peitzman, A., Sperry, J., and Brown, J. Speed is not everything: Identifying patients who may benefit from helicopter transport despite faster ground transport. Journal of Trauma and Acute Care Surgery 2018; 84:549-557

Cook, M., Holcomb, J., Rahbar, M., Alarcon, L., Bulger, E., Brasel, K., and Schreiber, M., on behalf of the PROMMTT Study Group. An Abdominal CT may be Safe in Selected Hypotensive Trauma Patients with Positive FAST Exam. Am J Surg. 2015, May; 209(5): 834-840.

Drew, B., Auten, J., Cap, A., Deaton, T., Donham, B., Dorlac, W., DuBose, J., Fisher, A., Ginn, A., Hancock, J., Holcomb, J., Knight, J., Koerner, A., Littlejohn, L., Martin, M., Morey, J., Morrison, J., Schreiber, M., Spinella, P., Walrath, B., and Butler Jr, F. The Use of Tranexamic Acid in Tactical Combat Casualty Care: TCCC Proposed Change 20-02. J Spec Oper Med. Fall 2020; 20(3):36-43.

Lauerman, M., Feeney, T., Sliker, T., Saksobhavivat, N., Bruns, B., Laser, A., Tesoriero, R., Brenner, M., Scalea, T., Stein, D. Lethal now or lethal later: The natural history of Grade 4 blunt cerebrovascular injury. Journal of Trauma and Acute Care Surgery. 78(6(:1071-1085, June 2015.

Shakur, H., Roberts, I., Bautista, R., Caballero, J., Coats, J., Dewan, Y., El-Sayed, H., Gogichaishvili, T., Gupta, S., Herrera, J., Hunt, B., Iribhogbe, P., Izurieta, M., Khamis, H., Komolafe, E., Marrero, M., Mejia-Mantilla, J., Miranda, J., Morales, C., Olaomi, O, Olldashi, F., Perel, P. Peto, R., Ramana, PV., Ravi, RR., and Yutthakasemsunt, S. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomized, placebo-controlled trial. Lancet. 2010, Jul 3; 376 (9734): 23-32.

Williams, J., Merutka, N., Meyer, D., Bai, Y., Prater, S., Cabrera, R., Holcomb, J., Wade, C., Love, J., and Cotton, B. Safety profile and impact of low-titer group O whole blood for emergency use in trauma. J Trauma Acute Care Surg. 2020; 88: 87-93.
Availability: On-Demand
Cost: FREE
Credit Offered:
1 CE Credit
1 COP Credit
1 TCAA CME Credit
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