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Self-Directed Skills Laboratories Increase Emergency Medicine Physician Confidence in High-Acuity, Low-Opportunity Procedures.
Mil Med
December 2024
Department of Emergency Medicine, Naval Medical Center Portsmouth, Portsmouth, VA 23708, USA.
Introduction: The critical role of emergency physicians in military settings underscores the necessity for a broad and proficient skill set, especially in life-saving procedures such as thoracostomies, endotracheal intubations, and cricothyrotomies, to maintain combat readiness. The current peacetime phase, however, presents challenges in maintaining these skills because of decreased exposure to high-acuity medical scenarios. This decrease in exposure jeopardizes skills retention among military emergency medicine physicians, highlighted by studies showing a significant decline in performance over time because of reduced practice.
View Article and Find Full Text PDFOpen aneurysmorraphy following branched and fenestrated endovascular repair of complex thoracic aneurysms.
J Vasc Surg
October 2024
Department of Vascular Surgery, Aortic Center, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, INSERM UMR_S 999, Université Paris Saclay, Le Plessis-Robinson, France. Electronic address:
Article Synopsis
- The study reviews a hybrid management approach for treating large thoracic aortic aneurysms (>80mm), combining endovascular techniques (TEVAR and FBEVAR) with open surgical repair without aortic cross-clamping.
- Researchers conducted a retrospective analysis of patients who underwent this treatment in two aortic centers from December 2017 to March 2024, focusing on patient outcomes such as survival, complications, and aneurysm size changes.
- Results showed a 100% survival rate within 30 days post-surgery and successful regression of the aneurysm sac in almost all patients, indicating that this hybrid method is both safe and effective for complex thoracic aneurysms.
Contemporary Video-Assisted Thoracoscopic Lobectomy for Early-Stage Lung Cancer.
J Laparoendosc Adv Surg Tech A
September 2024
Department of Surgery, The George Washington University Hospital, Washington, District of Columbia, USA.
The treatment of non-small cell lung cancer (NSCLC) has evolved tremendously in recent decades as innovations in medical therapies advanced concomitantly with minimally invasive surgical techniques. Despite early skepticism regarding its benefits, video-assisted thoracoscopic surgery (VATS) techniques for the surgical resection of early-stage NSCLC have now become the standard of care. After being the subject of many studies since its inception, VATS has been shown to cause less postoperative pain, have shorter recovery time, and have fewer overall complications when compared to conventional open approaches.
View Article and Find Full Text PDFA trauma expert consensus: Capabilities are required early to improve survivability from traumatic injury.
J Trauma Acute Care Surg
August 2024
From the Joint Trauma System (J.M.G., R.S.K., S.J., B.J.S., J.W., H.M., A.J.R.), Defense Health Agency, Joint Base San Antonio-Fort Sam Houston, Texas; Department of Surgery (J.M.G., S.S., S.J., E.M.), Department of Military and Emergency Medicine (R.S.K., E.M.), and Department of Pathology (A.J.R., E.M.), Uniformed Services University of the Health Sciences, Bethesda, Maryland; Department of Trauma and Acute Care Surgery (J.B.H.), University of Alabama at Birmingham, Birmingham, Alabama; The Geneva Foundation (A.M.S.), US Army Institute of Surgical Research, Joint Base San Antonio-Fort Sam Houston; Department of Surgery, Trauma and Acute Care Surgery (B.E.), University of Texas Health San Antonio, San Antonio, Texas; Joint Medical Unit (M.S.), Joint Special Operations Command, United States Special Operations Command, Fort Liberty, North Carolina; San Antonio Uniformed Services Health Education Consortium (M.S.), Joint Base San Antonio-Fort Sam Houston, Texas; Defense Health Agency (S.J., S.S.), Colorado Trauma Medical Director, Colorado Springs, Colorado; Department of Trauma and Acute Care Surgery (K.G.), Cooper University Medical Center, Camden, New Jersey; HNL Lab Medicine (E.M.), Allentown, Pennsylvania; and Armed Forces Medical Examiner System (W.W., A.J.R.), Defense Health Agency, Dover Air Force Base, Delaware.
Article Synopsis
- The study reviews US military fatalities from combat trauma between 2001 and 2021 to identify potential survival-benefitting interventions and improve trauma care systems.
- Out of 388 fatalities analyzed, 100 were identified as potentially survivable, with the majority occurring prehospital and involving severe injuries such as gunshot wounds.
- A panel of medical experts recommended 433 interventions, highlighting blood transfusion as the most critical prehospital intervention and thoracotomy as vital in hospital settings for improving survival outcomes.
Deep Circulatory Arrest and Left Thoracotomy Approach Allow Open Repair of Chronic IIIb Dissection Associated to a Large Aortic Arch: A Case Series.
Ann Vasc Surg
November 2024
Department of Vascular Surgery, Rouen University Hospital, Rouen, France. Electronic address:
Thoracic aortic aneurysms evolving within a type IIIb chronic aortic dissection are mostly treated with the deployment of an endograft. However, several cases of dissecting aneurysms are associated with a significant dilatation of the aortic arch. These cases are usually managed in 2 steps: arch reconstruction or supra-aortic trunk debranching at first and a secondary graft deployment for the descending thoracic aorta.
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