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Las Vegas – Trauma/Critical Care/Emergency General Surgery Conference

I’d like to take just a little space on my blog to talk about the 45th annual Las Vegas trauma conference. As usual, the facilities were fabulous. The format is truly remarkable. Unlike most scientific conferences, in this conference the focus is on delivering pertinent information quickly and efficiently. Many conferences drone on and on for hours. Instead, these lectures are confined to 15-20 minutes. That’s it. I’d like to highlight just a few of those lectures that I thought were interesting or particularly informative.

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By |2012-04-03T16:43:30-04:00April 1st, 2012|Healthcare|2 Comments

Las Vegas – Trauma/Critical Care/Emergency General Surgery Conference (Updated with video)

I’d like to take just a little space on my blog to talk about the 45th annual Las Vegas trauma conference. As usual, the facilities were fabulous. The format is truly remarkable. Unlike most scientific conferences, in this conference the focus is on delivering pertinent information quickly and efficiently. Many conferences drone on and on for hours. Instead, these lectures are confined to 15-20 minutes. That’s it. I’d like to highlight just a few of those lectures that I thought were interesting or particularly informative.


This is the last lecture of the conference. Dr. Ken Mattox takes his time and reviews all of the lectures. He does it all in about 20 – 30 minutes. Very informative. It is nice to hear his take on several big issues. Now, this start at the beginning of the conference.

The first lecture was called Admitting the Catastrophic Trauma Patient to the Remote Level IV Hospital. This lecture was given by Doctor Richard Sidwell. He thoughtfully laid out some of the problems encountered at the smaller hospitals. I’ve spent the last 10 years of my career at level II trauma centers. They are directly fed by the smaller hospitals. I’ve seen these hospitals struggle as just one or two patients can quickly overwhelm their systems. I’ve also seen many of these hospitals do a fabulous job at stabilizing patients and transferring them to definitive care. This was an excellent lecture.

The next lecture that I like to highlight was on TEG (thromboelastogram) by Dr. Kenji Inaba. Over the last several years, I’ve listened to several lectures which have suggested that the thromboelastogram should replace pro-time, international normalized ratio (INR) impartial thromboplastin time. I’m still somewhat skeptical, but it sure seems like we can get a lot of information from this one test.

Colorectal CrisisDoctor David Wisner emphasized the problems that internal medicine physicians and acute care surgeons are facing with Clostridium colitis. We’re seeing more and more of this. The question is, who needs surgery? We all understand that the literature suggests operating early is better than operating late, but you don’t want to have to take anything out if you don’t need to. Currently, clinical judgment still plays a huge role.

Doctor Hamed Amani gave a very interesting lecture on burn dressings. It seems to me, nearly once a month, the wound care nurses are suggesting a new burn dressing. This lecture was extremely informative.

Dr. Raul Coimbra suggested using hypertonic saline in patients with track brain injury. He presented, in my opinion, the most rational approach to using hypertonic saline.

Doctor Andre Campbell presented a nice discussion for using TPA in patients with retained hemothoraxes. I still believe that using video-assisted thoracoscopy is the best way to take care of these patients. In spite of my personal opinion, I thought his lecture was excellent.

Possibly, the most disappointing lecture was the New Endpoints of Resuscitation given by Doctor Rao Ivatury. His lecture was good. He did an excellent job reviewing the literature. The problem is that for decades we’ve been looking for a single marker which would tell us that patients have enough fluid or not enough fluid. Something that would tell us yes or no. We still don’t have that. We still have to look at multiple different endpoints in order to figure out if the patient has had enough fluid or not. In my opinion, this is a failure of research. Over the last several years, we’ve seen more and more data which suggests that if we overhydrate the patient, this is bad. On the other hand, we have decades of information suggesting that if we don’t give the patient enough fluid, this is also bad. So, how do we find the sweet spot?

There were other very nice lectures. These the ones that jump out at me. This was a great conference. I highly recommend it.

By |2012-04-01T20:43:39-04:00April 1st, 2012|Healthcare|2 Comments

Friday Night News Roundup

I’ve been enjoying a fabulous trauma conference in beautiful downtown Chicago. This is simply one of my favorite cities in all of the United States. The spring and fall will deliver weather that is unparalleled. Unfortunately, I got here just a little late in the season. It’s starting to get chilly. The Art Institute of Chicago is one of my favorite places.

Terrible plane crash in Reno, Nevada. Several deaths. Upwards of 50 or 60 injuries, according to some news reports. Very sad.

Inflation appears to be ticking up. This is really bad news. The things that the Federal Reserve can do to combat inflation hurt job growth and money availability. Most commonly, the Fed will increase interest rates and decrease the money supply. These actions will make money harder to come by and loans harder to come by. They will in turn cause a decrease in spending, which will then lead to prices coming down and breaking the back of inflation. I have no idea what the Fed does in the face of 9.1% unemployment, a stagnant economy and the beginnings of a bump in inflation. This is going to be interesting.

There was a special election in Anthony Wiener’s district in New York. The Democrat, somebody I’ve never heard of, lost to a Republican. There was/is a bunch of handwringing as, once again, the mainstream media is trying to convince the American people that this election was about Pres. Barack Obama. I find that most local elections are about local things. I think it is seldom the case that local elections are about national things. Maybe I’m wrong, but I think this election was about Anthony Wiener and his behavior. Barack Obama has plenty of other things to worry about.

Drone strikes in Yemen. There are some question whether the Yemeni government will collapse.

Somalia seems to be lapsing once again into famine. Unfortunately, the world has little or no stomach for aiding this dysfunctional and war-torn country.

A teenager in Horizon City, Texas is being brought up on charges of defrauding a community out of $17,000. It appears that the community believe that the teenager was dying of cancer.

I have no idea what’s going on in Egypt. Seems like there is chaos breaking out, again. There also seems there is a police crackdown, again.

There seems to be a real pathological brain injury associated with Gulf War syndrome. All I know is we need to take care of our troops. It’s our promise to them. As Americans, we must keep our promises.

If this story is true, I hope the prosecutor throws the book at this young lady. She “allegedly” started a charity for her lymphoma. She collected over $17,000 from a community called Horizon City, Texas. It turns out, she does not have cancer. This kind of behavior that we must stop in the United States. This is the kind of behavior that takes advantage of our good will and ruins our communities as we could begin to distrust each other about everything. (the earlier version of this news story made no sense. I have no idea what happened.)

There’s a new book about Sarah Palin and her life. This supposed to be some tell-all book. Stop it. A tell-all book? Why? I don’t like Sarah Palin because I think she is destructive. I don’t think that she has any answers for the problems of the United States. I really don’t care about some book that is not going to improve the economy or create jobs. Right now, the focus should be on jobs. That’s it. 24/7.

By |2011-09-16T23:52:53-04:00September 16th, 2011|Economy, General, Military, Party Politics|Comments Off on Friday Night News Roundup
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