The 2017 Creighton Trauma Symposium will take place on June 16 in Omaha, Nebraska. The theme of this year’s event is interprofessional collaboration. Expert speakers will discuss how collaboration is key to enhancing the quality and safety of trauma care.

Asensio on popliteal injuries

Juan A. Asensio, MD, FACS, chief of trauma surgery and surgical critical care at CHI Health Creighton University Medical Center and symposium director, will speak on “Popliteal Vessel Injuries, or the Battle of the Bulge for Trauma Surgeons.”

“Managing vascular injuries is a problem that continues to vex surgeons,” Dr. Asensio said. “One injury that has really baffled us as a group is popliteal vessel injury. We learned a lot about this injury in Vietnam, and it is really the classic Vietnam injury.”

However, Dr. Asensio explained, the changing nature of battle has led to different injury patterns.

“Soldiers today have body armor, so we do not see as many torso injuries, and extremity injuries are normally massive mangled extremities,” he said. “Yet we still need to teach younger surgeons about popliteal injury because the next war may be different. It may not always be IEDs that are driving injury in our troops.”

According to Dr. Asensio, popliteal vessel injuries remain a significant problem in many resource-poor countries. “Our goal is to adapt our previous military experience with popliteal injury to the civilian arena and merge the two areas so that younger surgeons will still be able to take care of these injuries and prevent people from losing limbs.”

Team approach to challenging cases

Michel Wagner, MD, FACS, assistant professor of surgery at Creighton University School of Medicine, will lead a multidisciplinary presentation entitled “Interprofessional Approach to Challenging Trauma Cases at Creighton University – Rural to Metro”.

The cases examined during this session highlight the challenges associated with extremity injury in the rural setting. Special guests for this session are patients Troy Farrens, RN, CEN, and Gayle Peters.

EMS experts will discuss the use of military tourniquets to treat these injuries at the scene — and the challenges of transferring patients to an urban trauma center. Hospital-based trauma providers will talk about managing these injuries in the trauma bay and beyond. The session will also cover the critical role of rehabilitation and recovery, with input from experts in physical medicine and psychiatry.

Duchesne on hemostatic resuscitation

The guest symposium faculty includes Juan Duchesne, MD, FACS, section chief of trauma/acute care surgery at Tulane University School of Medicine. The title of Dr. Duchesne’s presentation is “Hemostatic Resuscitation: What Is It? Is There A Benefit?”

“The goal of hemostatic resuscitation is to effectively resuscitate severely hemorrhaging patients with quality blood products, so we can transfer oxygen to cells and at the same time create a hemostatic balance,” Dr. Duchesne said. “It’s nothing new, but up to 30 percent of trauma patients present with severe coagulopathy. For these patients, we need to do hemostatic resuscitation.”

According to Dr. Duchesne, hemostatic resuscitation demands an interprofessional approach. “It is definitely multidisciplinary, because it involves coordination between prehospital providers, the ER, the resuscitation team itself, interventional radiology, and others.”

Moore on chronic critical illness

Frederick A. Moore, MD, FACS, chief of acute care surgery at UF Health Shands Medical Center, will speak on the “Evolving Epidemiology of Multiple Organ Failure (MOF) and Persistent Inflammation, Immunosuppression, and Catabolism Syndrome (PICS)”.

“We have gotten so good at taking care of patients in the ICU, that patients who used to die no longer do,” Dr. Moore said. “As a result, we have developed this cohort of patients, which is actually sizable, that are chronic critically ill.”

Dr. Moore and colleague Lyle Moldawer, PhD, have proposed PICS as a new phenotype of chronic MOF. “What we have proposed is that these patients develop a low-grade persistent inflammatory response, remain immune suppressed and remain in a catabolic state,” he said. “And all the things we do as good standards of care do not really prevent this from occurring.”

According to Dr. Moore, trauma and other critical care patients with PICS need multidisciplinary care. “When all the dust settles, these patients require novel alternative interventions, including intensive rehabilitation, good nutrition and an exercise program.”

Rathjen on burn care coordination

Esther Rathjen, MSN, APRN-CCNS, clinical nurse specialist at CHI Health St. Elizabeth, will talk about how trauma care providers can collaborate effectively with regional burn center staff. The title of her presentation is “Burn Patient Management: Outside Our Comfort Zone”.

“Most burn patients are not injured next to a verified burn center — they are injured 200 or 300 miles away, so it is important for trauma providers to know that the burn center team is always available to assist,” Rathjen said.

“I will focus on immediate care for burns and also talk about the resources that are available at the burn center, because when it comes to patient care we are all part of the same team.”

Full slate of topics

Other speakers and topics at this year’s trauma symposium include:

• Ernest E. Moore, MD: “Open & Complex Pelvic Fractures: The Multidisciplinary Approach”
• Jose Diaz, MD: “What Happens After Damage Control – The Open Abdomen: Challenges in Abdominal Wall Reconstruction”
• Eric Elster, MD: “History of Excelsior Surgical Society”
• Scott Brown, BSN: “The Trauma Patient Has Arrived in a Critical Access Hospital – What Do We Do!”
• Wendy Weber, PharmD, MBA: “Your Patient is Bleeding – Anticoagulant Reversal”

Register to attend

The conference will also feature special guest Richard Carmona, MD, the 17th Surgeon General of the United States. Dr. Carmona will deliver the symposium’s keynote address, “Prevention, Preparedness, Plagues, and Politics: The Life of the Surgeon General.”

This year’s Creighton Trauma Symposium coincides with the start of the 2017 NCAA Men’s College World Series baseball tournament. A few lucky symposium attendees will win tickets to the opening game on June 17.

This event is approved for continuing education credit for physicians, nurses, pharmacy and EMS providers. For more information and to sign up, visit the 2017 Creighton Trauma Symposium webpage.