Greetings from the London Trauma Conference!
As has become our pre-Christmas custom, Iain and I have been hanging out at the fabulous London Trauma Conference, hearing about advances and controversies in trauma care and tracking down some of the speakers to find out exactly what they really think (and recording it, for podcasts we’ll release in due course).
The conference extends over four days, incorporating the Air Ambulance and Prehospital Day and the Cardiac Arrest Symposium; unfortunately we can’t stick around for those but our colleagues over at the RCEM FOAM network will be podcasting from those days too, so keep an eye on their site and podcast feed too.
You can listen to the day 1 podcast round up here by clicking on the play button below.
So, what went down on day one?
First up we had Prof Tim Coats, speaking about trauma units and the challenges of delivering quality trauma care across the UK. We’ve recorded a separate podcast with him which we’ll bring you in due course, but the biggest message he brought us was on the changing face of trauma care – we’re no longer seeing the young male from an RTC but increasingly elderly patients with falls <2m – and that’s not how trauma systems in the UK were initially designed (and have been subsequently measured).
Next was Prof Kjetil Soreide on iatrogenic harms in trauma. His key messages seemed to be that human factors matter in trauma care, and he recognised the ED, ICU and operating theatre as areas of complex decision making in trauma; that the majority of errors related to “delays” in delivery of care and that error does not respect seniority – senior clinicians are making mistakes too!
Matt Thomas, an anaesthetist, ICU and PHEM doc from Bristol then took us through the latest published research likely to shape the future of trauma care. Again, we have a separate podcast coming from him but his last suggestion introduced (to me, at least) the idea of Trauma Risk Management, a concept from the military, to promote organisational wellbeing in practitioners exposed to the devastating sort of cases we deal with.
After lunch, the ever-effusive Mark Wilson talked about potential future modalities for identifying the nature of traumatic brain injury in the prehospital setting, hoping that we could target research into specific therapies and the delivery of anatomy-specific care to patients.
He chaired the first session of the afternoon which covered other neuro-trauma topics, including a fascinating talk by Geoffrey Raisman on spinal cord regeneration (check out the BBC video below for more on this groundbreaking case), Prof Andrew Maas on the bigger picture of head injury including the challenges of research in this area, and the very entertaining Markus Skrifvars on alcohol and head injury with an ever-relevant reminder that people who are intoxicated sometimes have coexisting TBI – and that early CT is the answer.
The afternoon kicked off with Karim Brohi talking up a genomic storm about the immune response to trauma – we don’t quite understand it yet but reassuringly it doesn’t look like anyone does quite yet – suffice it so say it probably isn’t a good thing! His talk was followed by a fantastic keynote speech from Jeff Upperman, a paediatric surgeon from LA, who outlined the terrifying scale of gun-related trauma in the US. Sobering indeed.
Ishay Ostfeld provided a unique Israeli perspective on mass-casualty events, explaining exactly why Israeli systems have adapted to “scoop and run” rather than “stay and play”, focusing on meaningful interventions (securing the airway, decompressing tension pneumothorax, control of compressible haemorrhage) during treat-and-transfer.
Mark Turner took us through developments in trauma-related blood transfusion (summary: it’s pretty complicated but we might have synthetic products to aid us in future) and the day finished with Susan Bundrage taking on some of the big trauma-related myths and highlighting the fact that there is no silver bullet when it comes to a single intervention to transform trauma care; it’s all about effective systems.
And that’s it for today! We’ll be back tomorrow for some more – join us then.
There will be more to come tomorrow and in future months.
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