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Trauma Anesthesiology

‌The mission of the Division of Trauma Anesthesiology is to provide high quality, state of the art anesthetic care to patients at the R Adams Cowley Shock Trauma Center. The R Adams Cowley Shock Trauma Center is the world’s first free-standing trauma center that initially opened in the 1970’s. A new Shock Trauma Critical Care Tower opened in 2013 and allowed us to meet increasing patient volume demands by adding additional beds to our critical care units. The Trauma Center serves as a referral center for over 8,000 patients in and around Maryland. The goal is to be the leading trauma center in the world, practicing evidence-based medicine and serving as a model for other trauma centers. The trauma anesthesia department is an integral part of the team that helps patients return to functional lives after tragedy, and to make that transition as seamless and comfortable as possible. This state-of-the-art trauma facility also serves as a model for military teams that the Anesthesiology Department takes pride in training through the Center for Sustainment of Trauma and Readiness Skills (C-STARS) program.

In addition to managing acute traumas, the Division also provides anesthesia for a variety of surgeries that include soft tissue infections, plastic, reconstructive and maxillofacial surgeries and orthopedic surgeries. The Division uses a multimodal approach when caring for patients that encompasses regional anesthesia techniques and alternative pain management therapies through our integrative medicine discipline when appropriate.

Research

Members of the Trauma Anesthesia faculty have been widely published. For example, published research areas have focused on resuscitation, evaluation of non-anesthesia airway trainees and traumatic brain injuries. Shock Trauma Center participated in a large multicenter research project known as the PROPPR study. This study investigated different ratios of blood products to control hemorrhage in trauma patients and the influence on long-term outcomes, such as survival and post-operative complications. Faculty are currently involved in a variety of projects such as assessing non-invasive monitors to assist pre-hospital providers with triage decisions or interdepartmental studies investigating oxygen concentration and outcomes in orthopedic patients. We are currently participating in a multicenter prospective trial of using circulatory arrest and deep hypothermia to facilitate timely surgical repair in patients who have sustained life threatening penetrating trauma.

Members of the Trauma Anesthesia faculty have been widely published. For example, published research areas have focused on resuscitation, evaluation of non-anesthesia airway trainees and traumatic brain injuries. Shock Trauma Center participated in a large multicenter research project known as the PROPPR study. This study investigated different ratios of blood products to control hemorrhage in trauma patients and the influence on long-term outcomes, such as survival and post-operative complications. Faculty are currently involved in a variety of projects such as assessing non-invasive monitors to assist pre-hospital providers with triage decisions or interdepartmental studies investigating oxygen concentration and outcomes in orthopedic patients. We are currently participating in a multicenter prospective trial of using circulatory arrest and deep hypothermia to facilitate timely surgical repair in patients who have sustained life threatening penetrating trauma.

Recent Publications

Vadlamani A, Perry JA, McCunn M, Stein DM, Albrecht JS. Racial Differences in Discharge Location After a Traumatic Brain Injury Among Older Adults. Arch Phys Med Rehabil. April 2019. PMID:30954440.

Galvagno SM Jr, Nahmias JT, Young DA. Advanced Trauma Life Support® Update 2019: Management and Applications for Adults and Special Populations. Anesthesiol Clin. 2019;37(1):13-32. PMID:30711226.

Matsushima K, Conti B, Chauhan R, Inaba K, Dutton RP. Novel Methods for Hemorrhage Control: Resuscitative Endovascular Balloon Occlusion of the Aorta and Emergency Preservation and Resuscitation. Anesthesiol Clin. 2019;37(1):171-182. PMID:30711230.

Galvagno SM Jr, Massey M, Bouzat P, Vesselinov R, Levy MJ, Millin MG, Stein DM, Scalea TM, Hirshon JM. Correlation Between the Revised Trauma Score and Injury Severity Score: Implications for Prehospital Trauma Triage. Prehosp Emerg Care. 2019;23(2):263-270. PMID:30118369.

McCunn M, Ahmed MI, Kuza CM. Modern Day Trauma Care for the Anesthesiologist. Anesthesiol Clin. 2019;37(1):xv - xvi. PMID:30711238.

Aarabi B, Olexa J, Chryssikos T, Galvagno SM, et al. Extent of Spinal Cord Decompression in Motor Complete (American Spinal Injury Association Impairment Scale Grades A and B) Traumatic Spinal Cord Injury Patients: Post-Operative Magnetic Resonance Imaging Analysis of Standard Operative Approaches. J Neurotrauma. 2019;36(6):862-876. PMID:30215287.

Slade IR, Samet RE. Regional Anesthesia and Analgesia for Acute Trauma Patients. Anesthesiol Clin. 2018;36(3):431-454. PMID:30092939.

Drumheller BC, Basel A, Adnan S, Rabin J, Pasley JD, Brocker J, Galvagno SM Jr. Comparison of a novel, endoscopic chest tube insertion technique versus the standard, open technique performed by novice users in a human cadaver model: a randomized, crossover, assessor-blinded study. Scand J Trauma Resusc Emerg Med. 2018;26(1):110. PMID:30587216.

Richards JE, Conti BM, Grissom TE. Care of the Severely Injured Orthopedic Trauma Patient: Considerations for Initial Management, Operative Timing, and Ongoing Resuscitation. Adv Anesth. 2018;36(1):1-22. PMID:30414633.

Manzano-Nunez R, Escobar-Vidarte MF, Orlas CP, Galvagno SM, et al. Resuscitative endovascular balloon occlusion of the aorta deployed by acute care surgeons in patients with morbidly adherent placenta: a feasible solution for two lives in peril. World J Emerg Surg. 2018;13:44. PMID:30258488.

 

Education

The Division is directly involved in educating medical students, nurse anesthetist students, residents and fellows. There are formal didactic sessions, lectures and rotations through a state of the art simulation center to develop clinical competencies. In addition, the department trains pre-hospital providers, emergency medicine residents and critical care fellows in airway management. The department offers a fellowship in Trauma Anesthesiology.

Faculty