2018 Trauma Symposium

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1 2018 Trauma Symposium Stop the Bleed Campaign FRIDAY, JUNE 15, 2018 Hilton Omaha Hotel 1001 Cass Street Omaha, Nebraska DESIGNED FOR: Trauma Surgeons, General Surgeons, Emergency Medicine Physicians, Physicians Providing Trauma and Critical Care, Primary Care Physicians, Nurse Practitioners, Physician Assistants, Pharmacists, Nurses, EMS Personnel, Fellows, Residents, Students, Public Health Professionals and Other Interested Health Care Providers JOINTLY PROVIDED BY: Creighton University School of Medicine Department of Surgery Division of Trauma Surgery and Surgical Critical Care CHI Health Creighton University Medical Center Trauma Program Creighton University EMS Education Creighton University College of Nursing Creighton University Health Sciences Continuing Education CHI Health LifeNet Air Medical Services Health Sciences Continuing Education

2 Schedule 7 a.m. Registration, Continental Breakfast and Visit Exhibits 7:15 a.m. Welcome and Introduction of Keynote Speaker Juan A. Asensio, MD, FACS, FCCM, FRCS (England), KM SESSION I Keynote MODERATOR: Juan A. Asensio, MD, FACS, FCCM, FRCS (England), KM 7:30 a.m. The Stop the Bleed Campaign Implications for the Care of Our Fellow Citizens Lenworth M. Jacobs Jr, MD, MPH, DSc (Hon), FACS, FWACS (Hon) 8:15 a.m. Session I Q&A Lenworth M. Jacobs Jr, MD, MPH, DSc (Hon), FACS, FWACS (Hon) Juan A. Asensio, MD, FACS, FCCM, FRCS (England), KM SESSION II Controversies and Challenges in Trauma Surgery MODERATOR: Michel Wagner, MD, FACS 8:30 a.m. Carotid Injuries Lethal Injuries Requiring Complex Surgical Techniques Juan A. Asensio, MD, FACS, FCCM, FRCS (England), KM 8:50 a.m. Bleeding Kills Andrew B. Peitzman, MD, FACS 9:10 a.m. The Navy s Role in Military and Civilian Catastrophes Miguel A. Cubano, MD, MBA, FACS 9:30 a.m. Session II Q&A Juan A. Asensio, MD, FACS, FCCM, FRCS (England), KM Miguel A. Cubano, MD, MBA, FACS Andrew B. Peitzman, MD, FACS Michel Wagner, MD, FACS 10 a.m. Break and Visit Exhibits SESSION III Secrets of the Master Trauma Surgeons MODERATOR: Juan A. Asensio, MD, FACS, FCCM, FRCS (England), KM 10:15 a.m. Traumatic Brain Injury Changes in Management Across the Spectrum of Age and Time Gail T. Tominaga, MD, FACS 10:35 a.m. Immunology in the Trauma Patient Christine S. Cocanour, MD, FACS, FCCM 10:55 a.m. Antibiotics in Trauma Patients Friends vs. Foes Philip S. Barie, MD, MBA, Master CCM, FIDSA, FACS 11:15 a.m. SESSION III Q&A Juan A. Asensio, MD, FACS, FCCM, FRCS (England), KM Philip S. Barie, MD, MBA, Master CCM, FIDSA, FACS Christine S. Cocanour, MD, FACS, FCCM Gail T. Tominaga, MD, FACS 11:45 a.m. Lunch and Visit Exhibits SESSION IV Contemporary Challenges for Nurses and Physicians MODERATOR: Carlos A. Fernandez, MD, FACS 12:45 p.m. Surgical Care of American Presidents How Would They Fare Today? Daria C. Ruffolo, DNP, RN, CCRN, ACNP-BC 1:15 p.m. Post-Traumatic Stress Disorder Pathophysiology, Pharmacology, and Impact on Combat Veterans Sriram Ramaswamy, MD 1:45 p.m. Session IV Q&A Carlos A. Fernandez, MD, FACS Sriram Ramaswamy, MD Daria C. Ruffolo, DNP, RN, CCRN, ACNP-BC 2 p.m. Break and Visit Exhibits SESSION V Interprofessional Approach to Challenging Trauma Cases at Creighton University from the Scene to Discharge MODERATOR: David L. Cornell, MD, FACS 2:15 p.m. Field Assessment in Transportation The EMS Perspective Gina Wood, EMT-P CCP 2:25 p.m. Patient Presentation from the Initial Presentation, Operative Intervention and Surgical Critical Care Samuel R. Brown, MD 2:45 p.m. Trauma Patients Rescue and Transportation Dilemmas and Challenges Alice Twink Dalton, RN, MS, CNS, NREMT-P 3:15 p.m. Pharmacological Challenges During Hemodynamic Instability The Pharmacologists Perspective Stacey K. Dull, PharmD, BCPS 3:25 p.m. Operative Challenges for the OR Nurse Robin Vineyard, RN, BSN, MSN, MBA 3:35 p.m. Surgical Critical Care Nursing Challenges Lindsey Swantek, RN, BSN Lauren B. Magill, RN, BSN 3:45 p.m. Evaluation and Adjournment 4

3 Jointly Provided by: Creighton University School of Medicine, Department of Surgery Division of Trauma Surgery and Surgical Critical Care CHI Health Creighton University Medical Center Trauma Program Creighton University EMS Education Creighton University College of Nursing Creighton University Health Sciences Continuing Education CHI Health LifeNet Air Medical Services The Symposium We will make every attempt to stay with the times that are printed on the schedule. Courtesy For the concentration and comfort of our participants, we ask that all cell phones and pagers be silenced during sessions of the conference. Breaks are provided for your communication convenience. Thank you for your cooperation. Breaks These times are designed to allow you the opportunity to take a pause from the content of this conference and to visit with other conference participants. We suggest you use this time to learn from others, share your ideas, and establish new professional contacts. Messages Please check at the registration table if you anticipate receiving calls. In the event of an emergency, today's program will be interrupted to deliver the message. Evaluations & Continuing Education Credit Certificates Following today s program, please go to the HSCE Website at Click on the Continuing Education tab located near the top right, then click on Course Evaluations. Please complete the evaluation for the 2018 Trauma Symposium by July 2, Upon completion of the evaluation, you will be automatically directed to a page to complete and print your continuing education certificate. The certificate you print will serve to document the continuing education credit you receive for the conference. Please keep the certificate for your records. If you have any questions, please contact Health Sciences Continuing Education at Thank You!

4 Acknowledgment This program is funded in part by financial support from the following companies which had no control over its content: Exhibits CHI Health Creighton University Medical Center Bergan Mercy Acelity Belmont CHI Health St. Elizabeth Burn Center CSL Behring DePuy Synthes Edwards Lifesciences Haemonetics Immanuel Rehabilitation Institute Integra which had no control over its content.

5 Acknowledgment This program is funded in part by financial support from the following companies which had no control over its content: Exhibits Janssen KLS Martin La Jolla LifeNet Air Medical Services Mallinckrodt Pharmaceuticals Masimo Midwest Medical Transport QuickClot Verathon - Glidescope Zimmer Biomet which had no control over its content.

6 Course Directors Juan A. Asensio, MD, FACS, FCCM, FRCS (England), KM Professor of Surgery and Vice-Chairman Chief, Division of Trauma Surgery & Surgical Critical Care Director of Trauma Center & Trauma Program, Department of Surgery Professor, Department of Clinical and Translational Science Creighton University School of Medicine CHI Creighton University Medical Center Omaha, Nebraska Adjunct Professor, Department of Surgery Uniformed Services University of the Health Sciences Walter Reed National Military Medical Center Bethesda, Maryland Michel Wagner, MD, FACS Assistant Professor of Surgery Department of Surgery Division of Trauma Surgery and Surgical Critical Care Assistant Professor, Department of Clinical and Translational Science Creighton University School of Medicine CHI Creighton University Medical Center Omaha, Nebraska Keynote Speaker Lenworth M. Jacobs, Jr, MD, MPH, DSc (Hon), FACS, FWACS (Hon) Professor of Surgery Professor of Traumatology and Emergency Medicine University of Connecticut Director, Trauma Institute at Hartford Hospital Chairman of the Hartford Consensus, Joint Committee to Increase Survival from an Active Shooter and Intentional Mass Casualty Event Member, Board of Regents, American College of Surgeons Hartford, Connecticut

7 Guest Faculty Philip S. Barie, MD, MBA, Master CCM, FIDSA, FACS Professor of Surgery and Professor of Public Health in Medicine Chief, Preston A. Wade Acute Care Surgical Service NewYork-Presbyterian Hospital/Weill Cornell Medical Center Weill Cornell Medicine New York, New York Christine S. Cocanour, MD, FACS, FCCM Section Chief, Surgical Critical Care Division of Trauma Surgery Director, Surgical Critical Care Fellowship Department of Surgery, University of California, Davis UC Davis Medical Center Sacramento, California Miguel A. Cubano, MD, MBA, FACS Associate Professor of Surgery Department of Surgery Uniformed Services University of the Health Sciences Walter Reed National Military Medical Center Bethesda, Maryland Commanding Officer of Naval Health Clinics Corpus Christi, Texas Alice Twink Dalton, RN, MS, CNS, NREMT-P EMS Director / Education Coordinator (Retired) Mountain View Fire Protection District Longmont, Colorado

8 Guest Faculty con t Andrew B. Peitzman, MD, FACS Professor and Executive Vice-Chairman Vice-Chairman, General/Community Surgery Mark M. Ravitch Chair in Surgery Chief, Division of General Surgery Vice-President for Trauma and Surgical Services, UPMC Department of Surgery University of Pittsburgh Former President American Association for the Surgery of Trauma (AAST) University of Pittsburgh Pittsburgh, Pennsylvania Daria C. Ruffolo, DNP, RN, CCRN, ACNP-BC Adjunct Faculty, Marcella Niehoff School of Nursing- Graduate School Acute Care Nurse Practitioner Department of Anesthesia Loyola University Medical Center Maywood, Illinois Gail T. Tominaga, MD, FACS Professor of Surgery Department of Surgery University of California, San Diego Chief, Trauma Section Scripps Memorial Hospital La Jolla La Jolla, California

9 Faculty Samuel R. Brown, MD Resident-Surgery Department of Surgery Creighton University School of Medicine David L. Cornell, MD, FACS Assistant Professor of Surgery Department of Surgery Division of Trauma Surgery and Surgical Critical Care Assistant Professor, Department of Clinical and Translational Science Creighton University School of Medicine CHI Creighton University Medical Center Stacey K. Dull, PharmD, BCPS Assistant Professor Department of Pharmacy Practice Creighton University School of Pharmacy and Health Professions Carlos A. Fernandez, MD, FACS Assistant Professor of Surgery Department of Surgery Division of Trauma Surgery and Surgical Critical Care Assistant Professor, Department of Clinical and Translational Science Creighton University School of Medicine CHI Creighton University Medical Center Lauren B. Magill, RN, BSN Trauma and Surgical Intensive Care Senior Nurse Department of Surgery, Division of Trauma Surgery CHI Health Creighton University Medical Center

10 Faculty con t Sriram Ramaswamy, MD Professor of Psychiatry Associate Chair for Research Creighton University School of Medicine Staff Psychiatrist U.S. Department of Veterans Affairs Lindsey Swantek, RN, BSN Trauma and Surgical Intensive Care Senior Nurse Department of Surgery, Division of Trauma Surgery CHI Health Creighton University Medical Center Gina Wood, EMT-P CCP Firefighter-PS, EMS Division Omaha Fire Department Robin Vineyard, BSN, RN Operating Room Supervisor and Surgical Coordinator Division of Trauma Surgery Department of Surgery CHI Health Creighton University Medical Center Planning Committee: Juan A. Asensio, MD, FACS, FCCM, FRCS (England), KM; Michel Wagner, MD, FACS; David L. Cornell, MD, FACS; Robert P. Bertellotti, MD, FACS; Carlos A. Fernandez, MD, FACS; Colin T. Dworak, BSBA; Michael G. Miller, EdD, MS, BSEMS, RN, NRP; Lindsay M. Iverson, DNP, APRN-NP, ACNP-BC; Jeremy Moore, CFRN; Katie Pierce, BSN, RN, CEN, CPEN; Kimberly E. Sieck, MSN, RN, CCRN-E; Devendra K. Agrawal, PhD; Brenda Welter

11 The following faculty and planning committee members have listed no financial interest/arrangement or affiliation that would be considered a conflict of interest. Devendra K. Agrawal, PhD Juan A. Asensio, MD, FACS, FCCM, FRCS (England), KM Philip S. Barie, MD, MBA, Master CCM, FIDSA, FACS Robert P. Bertellotti, MD, FACS Samuel R. Brown, MD Christine S. Cocanour, MD, FACS, FCCM David L. Cornell, MD, FACS Miguel A. Cubano, MD, MBA, FACS Alice Twink Dalton, RN, MS, CNS, NREMT-P Stacey K. Dull, PharmD, BCPS Colin T. Dworak, BSBA Carlos A. Fernandez, MD, FACS Lindsay M. Iverson, DNP, APRN-NP, ACNP-BC Lenworth M. Jacobs, Jr, MD, MPH, DSc (Hon), FACS, FWACS (Hon) Lauren B. Magill, RN, BSN Michael G. Miller, EdD, MS, BSEMS, RN, NRP Jeremy Moore, CFRN Andrew B. Peitzman, MD, FACS Katie Pierce, BSN, RN, CEN, CPEN Sriram Ramaswamy, MD Dario C. Ruffolo, DNP, RN, CCRN, ACNP-BC Kimberly E. Sieck, MSN, RN, CCRN-E Lindsey Swantek, RN, BSN Gail T. Tominaga, MD, FACS Robin Vineyard, RN, BSN Michel Wagner, MD, FACS Brenda Welter Gina Wood, EMT-P CCP

12 Ignatian Values in the Spirit of Creighton As a part of Creighton University s Mission, Ignatian values are a vital part of healthcare. Ignatian Values date back to the days of St. Ignatius Loyola, founder of the Society of Jesus (Jesuit Order). Ignatius believed that educators could teach students to care about others and motivate them to effect positive changes in the world around them. Ignatian Values in Continuing Education: Academic Excellence Acceptance & Understanding of inter-religious differences Service to Others, especially to poor and socially disadvantaged Interface between faith & culture Education of the Whole Person: intellectual, professional, moral and spiritual Learning is a lifelong process Respect for the dignity of each human person Promotion of a faith that does justice Forming of women and men of competence, conscience, and compassion Disclosure Policy It is the policy of Creighton University Health Sciences Continuing Education, to ensure balance, independence, objectivity and scientific rigor in all its educational activities. All faculty participating in this activity are expected to disclose to the audience any significant financial interest or other relationship he/she has with the manufacturer(s) of any commercial product(s) discussed in an educational presentation.

13 Education Credits Category 1 Creighton University School of Medicine designates this live activity for a maximum of 7 AMA PRA Category 1 Credit(s) TM. Physicians should claim only credit commensurate with the extent of their participation in the activity. AAPA accepts AMA category 1 credit for the PRA from organizations accredited by ACCME. Nurse CE Creighton University Health Sciences Continuing Education designates this activity for 7.0 contact hours for nurses. Nurses should claim only credit commensurate with the extent of their participation in the activity. Pharmacy Creighton University Health Sciences Continuing Education (HSCE) is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education (CPE). The 2018 Trauma Symposium is accredited for 7.0 hour(s) for completion of all CE Sessions on. The 2018 Trauma Symposium is a knowledge-based activity. AAFP This Live Activity 2018 Trauma Symposium, with a beginning date of 06/15/2018, has been reviewed and is acceptable for up to 6.75Prescribed credit(s) by the American Academy of Family Physicians. Physicians should claim only the credit commensurate with the extent of their participation in the activity. EMS This educational activity has been approved for up to 6.75 continuing education hours for all levels of EMS personnel through Creighton University. Accreditation Statement In support of improving patient care, this activity has been planned and implemented by Creighton University Health Sciences Continuing Education CHI Health and LifeNet Air Medical Services. Creighton University Health Sciences Continuing Education (HSCE) is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

14 **Important please complete this worksheet before starting the online evaluation** Continuing Education Credit Worksheet 2018 Trauma Symposium Please tabulate your credits on this worksheet before taking the online evaluation. This worksheet information will be needed when completing your HSCE credit certificate following the evaluation. Friday, Notes Session I 1.00 Credits Session II 1.50 Credits Session III 1.50 Credits Session IV 1.50 Credits Session V 1.50 Credits Total Credits Possible: 7.00 Credits Please note this is a worksheet only and not a certificate of attendance. Following today s program, please go to the HSCE Website at Click on the Continuing Education tab located near the top right, then click on Course Evaluations located on the left side of the page. Please complete the evaluation for the 2018 Trauma Symposium by June 30, Upon completion of the evaluation, you will be automatically directed to a page to complete and print your continuing education certificate. The certificate you print will serve to document the continuing education credit you receive for the conference. Please keep the certificate for your records. If you have any questions, please contact Health Sciences Continuing Education at

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