Release and Expiration Dates
Released: 6.15.2022
Expires: 6.14.2025
Last Reviewed Date
6.14.2022
2022 Trauma University: Management of Multiple Trauma Patients
TCAA's Trauma University is designed to provide practitioners with cutting edge clinical education. Based on TCAA member recommendations, 2022's presentation provides a comprehensive review of a complex case covering multiple generations of trauma patients. The case addresses clinical concerns from EMS thru the rehabilitative stages of trauma care that involve multi-disciplinary providers.
Estimated completion time: 4 hours and 15 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. Describe the principles of scene management
2. Define best practices utilized in different age spans of trauma patients
3. Describe the benefits of social workers, child life and rehab specialists in the care of trauma patients
Moderator: Charles Mains
Faculty Presenters: Thomas Resignolo, Jerry Rubano, Britt Wells, Angela Martin, Barbara Romito, Karen Gudic, Britt Christmas, Eric Spier
Faculty Bios:
Dr. A. Britt Christmas: A. Britton Christmas received his B.A. degree from the University of Virginia in Charlottesville in 1996 and his M.D. degree from the University of Louisville School of Medicine in 2000. He completed his internship, residency, and surgical critical care fellowship in the Department of Surgery at the University of Louisville from 2000-2006 where he was inducted into the Alpha Omega Alpha Honor Medical Society. He joined the faculty of The F. H. "Sammy" Ross, Jr. Trauma Center at Carolinas Medical Center (Atrium Health) in Charlotte, North Carolina in 2006 where he currently serves as an attending surgeon for trauma, critical care, and acute care surgery, Professor of Surgery, and Medical Director and Chief of Trauma at one of the nation's busiest trauma centers. Dr. Christmas also obtained his Master of Business Administration degree from the East Carolina University College of Business in 2021. He has authored/co-authored more than 80 peer reviewed publications, 8 book chapters, and nearly 200 presented abstracts. Society memberships include the American College of Surgeons (ACS), the Eastern Association for the Surgery of Trauma (EAST), the Pediatric Trauma Society, the American Association for the Surgery of Trauma (AAST) and the Southern Surgical Association. He is a former recipient of the EAST Leadership Development Scholarship, the recipient of the inaugural EAST Foundation Brandeis Scholarship in Health Policy and Management, and the recipient of the 2016 ACS Young Fellows Leadership and Advocacy Summit Scholarship. He is a Past-President of EAST and currently serves on the Board of Directors and Executive Committee for the Trauma Centers Association of America (TCAA) as Secretary, and as Vice Chair for the North Carolina ACS Committee on Trauma. Current national committee appointments include the TCAA Finance and Education Committees and the EAST Development Committee.
Dr. Angela Martin: Angela Martin went to the University of Missouri-Columbia for medical school. She completed her residency in OBGYN at Emory university and stayed there for her fellowship in Maternal-Fetal Medicine. Dr. Martin Joined faculty at the University of Kansas in 2016. She is currently a Clinical Assistant Professor of maternal-fetal medicine. Since joining faculty, she has won several teaching awards at KU including the American College of Obstetrics and Gynecology National Faculty Award and an Excellence in Teaching Award from the Association of Professors of Gynecology and Obstetrics. She has enjoyed performing retrospective cohort projects in topics such as preterm birth, fetal growth restriction, and trial of labor after cesarean section. She has served on the hospital pharmacy and therapeutics committee for several years and has been involved in the OB quality committee. Most recently she has enjoyed her role as the medical director of labor and delivery.
Barbara Romito: Barbara Romito, MA, CCLS, has served as the Director, Child Life Program at the Bristol-Myers Squibb Children's Hospital at Robert Wood Johnson University Hospital for over 30 years. She oversees child life services and family centered care, developing innovative programs to enhance psychosocial care for children and families. She has lectured extensively to a variety of interdisciplinary groups and published research studies on psychosocial care of children and families. She received her MA in family studies from Montclair State University, has served on the boards of The Child life Council, Child Life of Greater NY, and is currently the Association of Child Life Professionals' liaison to the American Academy of Pediatrics, Committee on Hospital Care. In 2021, she authored the AAP Policy Statement on Child Life Services. She serves as an adjunct instructor at Rutgers, Robert Wood Johnson Medical School, Department of Pediatrics.
Dr. Britt Wells: I am a board-certified orthopedic surgeon with 20 years of practice experience. I am currently employed with St. Luke's Orthopedics in Boise Idaho as a full time orthopedic hospitalist. My current practice is tailored to general orthopedics with a specialty focus in orthopedic trauma and the inpatient care of urgent and emergent orthopedic patients. I graduated Summa Cum Laude from Saint Louis University School of Medicine in 1997 and completed my internship and residency at the University of Arkansas for Medical Sciences in 2002. I fulfilled the requirements for board certification for the American Board of Orthopaedic Surgery in 2004 and recertified in 2014 scoring in the 97th percentile on the general clinical recertification examination. I served 4 years active duty military service in the United States Navy as a lieutenant commander from 2002 through 2006 appointed as the department head of orthopedic surgery at Naval Hospital Lemoore California. Upon completion of my military service, I joined Bone & Joint Surgeons, a private practice orthopedic group in the Dayton Ohio area where I enjoyed a successful private practice for 9 years. While in Dayton I practiced general and acute care orthopedics covering call at level I, II and III trauma centers. In 2015 I relocated with my family to my hometown of Boise Idaho where I accepted a position with the St. Luke's Orthopedic Clinic. I am currently the medical director of the hip fracture center of excellence program for St. Luke's Medical Center. In my free time I enjoy being a devoted husband to my wife Courtney of 29 years and an active father to our 3 children. My personal interests and activities including snow skiing, mountain biking, hiking, ATV'ing, weight lifting, reading, movies, music, traveling and spending time with my family.
Dr. Eric Spier: After finishing an internship at Yale in Internal Medicine and a residency at Baylor in PM&R, Dr. Spier moved back to his hometown of El Paso, TX to practice. While there he developed a brain injury program for patients in the inpatient, outpatient, and residential settings. Dr. Spier managed a spectrum of services from spasticity management to medical direction and program development. He moved to Denver in 2016 to work at Craig Hospital and has since taken over as Director of the Brain Injury program. He serves as the Medical Director for both the Brain Injury Alliance of Colorado and the Academy of Certification for Brain Injury Specialists. He has worked on boards devoted to developing guidelines for workmen's compensation in Colorado as well as for Health Policy and Legislation at the federal level. He is a contributing author in Brain Injury Medicine text books and participates in research in the model systems setting. His current interests lie in developing and advancing best practices for behavioral management and systems of care for people with acquired brain injury. He is currently licensed to practice medicine in Colorado and Texas.
Dr. Jerry Rubano: I serve as the trauma medical director and the chief of the Surgical/Trauma ICU at Long Island Community Hospital Campus of NYU Langone Health. My specialty lies in acute care surgery, as well as high risk general surgery and complex abdominal wall reconstruction.
As an acute care surgeon, I treat patients who come to the emergency department with a variety of diseases. I remove gallbladders, repair hernias, and manage appendicitis, bowel obstruction, abscesses, and necrotizing fasciitis, a dangerous bacterial infection.
I also care for patients who have experienced blunt injuries, which may be caused by a car accident, a fall, or other trauma. In addition, I manage penetrating injuries, such as gunshot or stab wounds. Traumatic injuries can change people's lives in an instant. I pride myself on not only managing patients' injuries but also assisting them with their recovery.
In addition to performing emergency surgery, I offer elective procedures, including removing soft tissue masses and the gallbladder. I see patients who need a second opinion as well as those who require revision surgery. I perform abdominal wall reconstruction for patients who have complex hernias, as well as those whose hernia repairs have failed. Additionally, I perform procedures on patients who are considered high-risk because they have multiple health conditions, such as cancer or heart disease, or are waiting for a transplant.
I conduct research focused on the quality of trauma care and advanced mechanical ventilation. During the early stages of the COVID-19 pandemic, I opened one of the first COVID-19 intensive care units in the region, at Stony Brook University Hospital. My colleagues and I have published multiple papers on COVID-19 treatment, and we are studying better ways to measure oxygen levels in people who have COVID-19.
In 2021, I was honored to receive the Healthcare Hero award. I was selected by Suffolk County legislator Kara Hahn for providing exceptional care to patients with COVID-19.
Thomas Resignolo: Thomas (TR) has been involved in emergency medical services for almost 40 years. He has worked as a firefighter, paramedic, ski patroller, search and rescue paramedic, SAR dog handler and EMS educator. TR developed the first wilderness paramedic program in the country and continues to provide medical coverage for various backcountry events throughout the year such as the Colorado 500, 600 and Project Healing Waters. He is currently the EMS Coordinator for St. Anthony Summit Medical Center in Frisco Colorado. When not working you will find him camping and fly fishing in the Everglades and Southwest Florida.
Karen Gudic:
Karen Gudic is a licensed social worker with over twenty years’ experience with of her experience focusing on trauma, domestic violence, child abuse and neglect and Human Trafficking and Sexual exploitation. She has been working at Cardinal Glennon Children’s Hospital for the past 13 years. For the past 7 years, she has been the designated trauma social worker.
References
D. El Kady, W. M. Gilbert, J. Anderson, B. Danielsen, D. Towner, and L. H. Smith, “Trauma during pregnancy: An analysis of maternal and fetal outcomes in a large population,” in American Journal of Obstetrics and Gynecology, 2004.
S. MA and H. VL, “Pregnancy outcomes following hospitalization for motor vehicle crashes in Washington State from 1989 to 2001.,” Am. J. Epidemiol., 2005.
J. Jang, K. T. Hsiao, and E. T. Hsiao-Wecksler, “Balance (perceived and actual) and preferred stance width during pregnancy,” Clin. Biomech., 2008.
D. El Kady, “Perinatal outcomes of traumatic injuries during pregnancy,” Clinical Obstetrics and Gynecology. 2007.
V. Katz, K. Balderston, M. Defreest, M. Nageotte, and J. Parer, “Perimortem cesarean delivery: Were our assumptions correct?,” in American Journal of Obstetrics and Gynecology, 2005.
Rose CH, Faksh A, Traynor KD, Cabrera D, Arendt KW, Brost BC. Challenging the 4- to 5-minute rule: from perimortem cesarean to resuscitative hysterotomy. Am J Obstet Gynecol. 2015 Nov;213(5):653-6, 653.e1.
H. Mendez-Figueroa, J. D. Dahlke, R. A. Vrees, and D. J. Rouse, “Trauma in pregnancy: An updated systematic review,” American Journal of Obstetrics and Gynecology. 2013.
J. Jensen et al., “Effects of Intimate Partner Violence on Pregnancy Trauma and Placental Abruption,” J. Women’s Heal., 2010.
J. Ali, A. Yeo, T. J. Gana, and B. A. McLellan, “Predictors of fetal mortality in pregnant trauma patients,” in Journal of Trauma - Injury, Infection and Critical Care, 1997.
M. A. Schiff, “Pregnancy outcomes following hospitalisation for a fall in Washington State from 1987 to 2004,” BJOG An Int. J. Obstet. Gynaecol., 2008.
H. B. Weiss and S. Strotmeyer, “Characteristics of pregnant women in motor vehicle crashes,” Inj. Prev., 2002.
C. Glantz and L. Purnell, “Clinical utility of sonography in the diagnosis and treatment of placental abruption,” J. Ultrasound Med., 2002.
S. C. Tinker, J. Reefhuis, A. M. Dellinger, and D. J. Jamieson, “Maternal injuries during the periconceptional period and the risk of birth defects, National Birth Defects Prevention Study, 1997-2005,” Paediatr. Perinat. Epidemiol., 2011.
Jeejeebhoy et al.; American Heart Association Emergency Cardiovascular Care Committee…Cardiac Arrest in Pregnancy: A Scientific Statement From the American Heart Association. Circulation. 2015 Nov 3;132(18):1747-73.
D. M. Moorcroft, J. D. Stitzel, G. G. Duma, and S. M. Duma, “Computational model of the pregnant occupant: predicting the risk of injury in automobile crashes.,” Am. J. Obstet. Gynecol., 2003.
D. A. Raptis et al., “Imaging of Trauma in the Pregnant Patient,” RadioGraphics, 2014.
S. Einav, N. Kaufman, and H. Y. Sela, “Maternal cardiac arrest and perimortem caesarean delivery: Evidence or expert-based?,” Resuscitation. 2012.
Mendez-Figueroa H., et al; Trauma in Pregnancy: an Updated Systemic Review. Am J Obstet Gynecol 2013; 209: pp. 1-10.
MacArthur B, Foley M, Gray K, Sisley A. Trauma in Pregnancy: A Comprehensive Approach to the Mother and Fetus. Am J Obstet Gynecol. 2019 May;220(5):465-468.e1.
Barraco, Robert D. MD, MPH, et al. Pregnancy and Trauma, Practice Management Guidelines for the Diagnosis and Management of Injury in the Pregnant Patient ; J Trauma, 69 (1):211-4. July 2010.
Peer Reviewer
Kim Wallenstein
James W. Eubanks, III
Jennifer Gratton