TRAUMA-ING

In this episode, Rob and I sit down with Judah Goldstein and Jenn Greene from Emergency Health Services (EHS) to dive deep into the Prehospital Evidence-based Practice (PEP) project . We explore how this massive repository is shaping paramedic practice, how evidence reviews are conducted, and then unpack the current science behind two critical clinical interventions: pelvic binders and prehospital FAST exams. We also talk about how boney Rob’s knees are and how we aren’t really clear if he knows how to work computers. For trauma things go to www.trauma-ing.com Check out the PEP database here: EMSPEP Database (TOC)

In this episode of TRAUMA-ING , James and Rob hang out with guest expert Dr. Rob Leeper to break down the intense, high-stakes world of ECMO in trauma resuscitation . They dive into the tough decision-making behind when to actually pull the trigger on mechanical circulatory support for trauma patients. Dr. Leeper shares some awesome pearls, real-world clinical insights, and the actual logistical hurdles of managing these incredibly sick patients. It is a casual but incredibly sharp conversation packed with practical strategies that any intensivist, trauma surgeon, or ED doc can use in their toolkit. Check out www.trauma-ing.com for more cool trauma stuff

In this episode, James and Rob sit down with Dr. Nori Bradley — trauma and acute care surgeon at the University of Alberta Hospital, intensivist, ATLS contributor, and one of the over 200 global experts who helped reshape the 11th edition — to break down the most clinically significant updates to the world’s leading trauma education program. The conversation digs into the headline change: the evolution of ABCDE to xABCDE, formally codifying exsanguinating hemorrhage control as the first priority before airway management, and what that shift actually means at the bedside. They explore the increased emphasis on hemodynamic optimization before RSI, the reorganization of the manual into three major sections, the entirely new Trauma Systems chapter, and how the 11th edition addresses team communication, special populations, and global applicability. Dr. Bradley offers an insider perspective on how the revision process unfolded, where the evidence drove change versus where expert consensus led, and what trauma providers — whether ATLS veterans or first-timers — most need to know before they walk into their next course.

In this episode of Trauma-ING, hosts Drs. James Gould and Rob Green welcome back Drs. Christian Malo (Quebec City) and Luiz Da Luz (Sunnybrook, Toronto) to break down the top trauma resuscitation papers of 2025, selected by surveying trauma team leaders across Canada. The four papers covered are: (1) a retrospective whole blood study showing no overall mortality benefit versus component therapy, but an intriguing signal of benefit in penetrating trauma specifically; (2) a systematic review supporting thoracic irrigation at the time of chest tube placement for traumatic hemothorax, showing reduced failure rates and infectious complications — a practice common in western North America but rarely done in the east; (3) Luiz’s own multicenter Canadian RCT comparing fibrinogen concentrate + PCC versus plasma, stopped early for futility but hinting at a mortality signal worth pursuing in a redesigned trial; and (4) an updated EAST guideline on TXA, conditionally recommending routine use both in-hospital and pre-hospital for patients at risk of hemorrhage, with a two-gram total dose for more trauma stuff go to www.trauma-ing.com

In this episode, James Gould and Rob Green sit down with Dr. Brian Lahiffe to discuss the Modified Brain Injury Guidelines (mBIG) — a risk stratification tool that is changing how emergency physicians disposition patients with mild traumatic brain injury and intracranial hemorrhage on CT. Dr. Lahiffe walks us through the three-tiered mBIG framework, how it guides decisions around neurosurgical consultation, repeat imaging, and safe discharge, and the important caveats that apply — including anticoagulation and antiplatelet use. The conversation covers practical, real-world application of mBIG in the ED so you can approach your next head injury with clarity and confidence. Go to www.trauma-ing.com for more FOAM stuff on trauma

In this episode, we sit down with Winny Li from Sunnybrook Health Sciences Centre to explore the Trauma Team Video Review (TTVR) program and its growing role in trauma care. Winny Li is a clinician and quality improvement leader with expertise in trauma systems, simulation, and patient safety. She has been closely involved in the development and implementation of video review initiatives aimed at improving team performance and clinical outcomes. We start by breaking down what trauma video review programs are and how they work in practice. The conversation highlights how these programs create powerful opportunities for learning, system improvement, and enhanced team communication. We also dive into the real-world challenges of implementing TTVR, including concerns around privacy, medicolegal risk, cost, and cultural resistance. Importantly, we discuss practical solutions and strategies that have helped overcome these barriers, including stakeholder engagement, governance frameworks, and fostering a culture of psychological safety. Whether you're involved in trauma care, education, or quality improvement, this episode offers valuable insights into how video review can transform team learning and patient care. For more FOAM trauma stuff go to www.trauma-ing.com

In this episode, we sit down with Dr. Andrew W Kirkpatrick, Major (retired), trauma surgeon and critical care specialist based in Calgary, and Dr. Shane Smith, Lieutenant Colonel and vascular, trauma, and general surgeon at Western University. Dr. Kirkpatrick was a key pioneer in the development of the RAPTOR (Resuscitation with Angiography, Percutaneous Techniques, and Operative Resuscitations) suite in Calgary, one of the earliest and most influential hybrid trauma resuscitation environments in North America. Together, we explore the evolution of RAPTOR/THOR (Trauma Hybrid Operating Room) concepts and how they are reshaping the management of severely injured patients. We discuss the core benefits of these hybrid environments—most notably the ability to deliver definitive hemorrhage control faster by combining operative and endovascular capabilities in a single location, while minimizing delays and risks associated with patient transfers. We also examine an important limitation: without thoughtful, forward-looking design, these suites risk becoming outdated. Rapid advances in standalone angiography and interventional technologies can outpace earlier-generation RAPTOR builds, highlighting the importance of flexibility and future-proofing when investing in these high-resource systems. Check out www.trauma-ing.com for more FOAM trauma stuff

We sit down with Amber Humes and Dr. John Armstrong, experts in MCI's to discuss how TNS and our health systems are preparing for these events. What is an MCI? How do we triage patients, how does the care differ from standard care? For more trauma stuff go to www.trauma-ing.com

We sit down with TTL and trauma consultant Dr. Sean Hurley to discuss his approach to bedside imaging and CT scan in trauma patients. We talk about utility of POCUS and Xray at the bedside, and the various different CT imaging modalities and when to use them. For more trauma stuff go to www.trauma-ing.com

James and Rob go live again for an Ask Me Anything episode. They tackle such questions as optimal use of TXA, permissive hypotension, hand over, and whether Rob has ever “moshed” at a Metallica concert. For more FOAM trauma stuff go to www.trauma-ing.com

In this episode of Trauma-ing , hosts James Gould and Rob Green are joined by Mike Rivers-Bowerman, a staff interventionalist at the QEII, for an in-depth discussion on the role of Interventional Radiology (IR) in trauma care. We explore what IR is, when and why it should be used in the trauma setting, and walk through some of the key techniques commonly employed. The conversation also covers important considerations for post-IR monitoring, highlighting how IR integrates into the broader trauma pathway and improves patient outcomes. For more FOAM trauma stuff go to www.trauma-ing.com

In this Trauma-ing Resus Rewind, we replay a standout episode from The Resus Course featuring Dr. Eve Purdy on relational coordination in resuscitation. The conversation explores how high-performing resus teams depend not just on technical skill, but on shared goals, shared knowledge, and mutual respect across disciplines. Eve breaks down why communication, role clarity, and relationships matter most when stakes are high, and how investing in these human factors improves patient outcomes and team performance. A timely reminder that great resuscitation is a team sport—and relationships are part of the resus toolkit. For more trauma resus stuff go to www.trauma-ing.com

In this replayed episode from THE RESUS COURSE podcast, Dr. Sean Hurley and James Gould discuss a practical, resuscitation-focused approach to penetrating neck trauma, covering how and when to intubate, how to recognize hard and soft signs of significant injury, and strategies for investigating and managing airway, vascular, and digestive tract injuries in it’s initial resuscitation phase For more trauma resus stuff go to www.trauma-ing.com

In this trauma-ing episode, we sit down with Dr. Paul Atkinson to explore compassionomics—the science behind why compassion matters in healthcare. Dr. Atkinson breaks down the critical differences between sympathy, empathy, and compassion, and explains how compassion goes beyond feeling to action. We discuss the growing evidence that compassionate care improves patient outcomes, strengthens trust in our trauma system, and enhances team performance. Importantly, he also reframes compassion as a protective strategy for clinicians, showing how it can reduce moral distress and help guard against burnout rather than contribute to it. This episode is a timely reminder that compassion is not a soft skill, but a measurable, system-level intervention that benefits patients and providers alike. For more FOAM trauma stuff go to www.trauma-ing.com

James and Rob sit down with Dr. Matthew Mackin for a Trauma-ing episode that digs into his recent trauma fellowship at the legendary R Adams Cowley Shock Trauma Center in Baltimore. Now back home as one of our trauma team leaders and trauma consultants—and bringing his anesthesiology expertise with him—Matt shares what life was really like inside one of the busiest trauma centres in the world. We explore the practices and culture he hopes to transplant into our own system, including a renewed emphasis on subclavian lines during resuscitation, broader use of regional anesthesia, and several other high-impact habits from Shock Trauma’s playbook. For more FOAM trauma related content head to www.trauma-ing.com

In this Trauma-ing Journal Club episode, we break down three timely studies shaping trauma care at the bedside and in the bay. First, we look at Perera et al.’s prehospital comparison of non-invasive versus arterial blood pressure monitoring, where NIBP consistently missed the mark in both shock and hypertension—who then should get art lines and when? We then dive into the TRAUMOX2 randomized trial, which challenges our instinct to “turn the oxygen up,” showing no mortality difference between restrictive and liberal oxygen strategies but hinting at fewer pulmonary complications with moderate targets. Finally, we unpack Burt et al.’s meta-analysis on early fibrinogen replacement in traumatic haemorrhage, finding no clear mortality or transfusion benefit despite its widespread use and highlighting the need for stronger evidence in the sickest, most coagulopathic patients. Go to www.trauma-ing.com for more FOAM trauma stuff

In this special live episode of Trauma-ing, James and Rob sat down with Mitchell and his dad, Bob, to revisit their incredible journey following a devastating MVC five years ago that left Mitchell with a severe TBI. Initially, his injuries were so grave that organ donation was discussed—but thanks to the dedication of our trauma system and the care teams across the QEII Health Sciences Center, he’s now living independently. Together, we explored their experience from the moment of the crash through rehabilitation, highlighting what went well, what mattered most to them along the way, and their advice to healthcare providers caring for patients and families facing similar life-altering injuries.

In this special episode of Trauma-ing with Dr. James Gould and Dr. Rob Green , we unpack the new Trauma Nova Scotia (TNS) cervical spine clearance pathway —a bold, evidence-driven initiative aimed at optimizing cervical spine assessment in trauma patients. Join Dr. Gould and Dr. Green as they walk you through the rationale behind the pathway For more FOAM trauma related content go to www.trauma-ing.com

In this Trauma-ing episode, Rob and I dig into the Massive Hemorrhage Protocol—when to activate, balancing blood products, and key elements like calcium, fibrinogen, and labs—along with a look at the lethal triad versus the lethal diamond and how these shape bedside decisions. Check out www.trauma-ing.com for more FOAM trauma content

Welcome to the very first Rapid Infuser episode—where we give you a fast push of trauma knowledge, straight lined into your brain. This time we’re talking about the rapid infusers themselves: the Belmont and the Level 1. We’ll hit the highlights on how they work, and drop a few clinical pearls that’ll help you keep blood moving when it matters most. Short, sharp, and just enough volume to keep your brain perfused. Check out this link here for steps on priming the Belmont For more FOAM trauma related content go to www.trauma-ing.com