Bryan Cotton @bryanacotton1 Twitter profile

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Bryan Cotton

@bryanacotton1

6 years

Suspicious Package Sent to Orthopeadic Department, contains Stethoscope

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Bryan Cotton

@bryanacotton1

4 years

Stop. Avoiding. Contrast. Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study

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Bryan Cotton

@bryanacotton1

3 years

“You don’t practice things until you get it right, you practice it until you can’t get it wrong.” Nick Saban #10000hours #outliers @Gladwell

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Bryan Cotton

@bryanacotton1

4 years

New lead finally came in!!! No Star Wars or superhero options offered... Me: “ what is the most obnoxious pattern you have?” Them: [see pic] Me: “I’ll take it!!!”

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Bryan Cotton

@bryanacotton1

11 months

#MakeBloodWholeAgain That is all.

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Bryan Cotton

@bryanacotton1

4 years

901. That’s # of trauma admits at RedDukeTraumaInstitute @memorialhermann May 2020. Up 100 over last May. Busiest month in our history. Puts us on course >10k this year. If u can’t wrap ur brain around it, places I trained for residency & fellowship see <4K/year. Combined. 🥵🥵🥵

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Bryan Cotton

@bryanacotton1

5 years

Been waiting 2 see 4 a while. Penn found vasopressin ⬇️ blood transfusions in hemx shock. Strong work! RCT of the Effect of Low-Dose Supplementation of Arginine Vasopressin on Need for Blood Product Transfusions in Patients With Trauma+Hemorrhagic Shock

Arginine Vasopressin Supplementation in Early Traumatic Shock

This randomized clinical trial assesses whether low-dose supplementation of arginine vasopressin during the resuscitation of hemorrhagic shock decreases the need for transfusions in patients with...

jamanetwork.com

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Bryan Cotton

@bryanacotton1

7 years

Please keep our Trauma Center neighbors in your thoughts and prayers

Brett Buffington

@BBuffingtonNews

7 years

#BREAKING Ben Taub Hospital, in the Texas Medical Center, is being evacuated... The most critical patients are leaving first. #khou11

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Bryan Cotton

@bryanacotton1

2 years

Saving lives in trauma. And they don’t even know it…

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Bryan Cotton

@bryanacotton1

3 years

Okay, say it with me: Crystalloids..."Crystalloids"... Suck..."Suck"... In hemorrhage..."in hemorrhage." That is all. Class dismissed. Prehospital Blood Product and Crystalloid Resuscitation in... : Annals of Surgery

Prehospital Blood Product and Crystalloid Resuscitation in... : Annals of Surgery

y. Large volume crystalloid resuscitation can be deleterious. The benefits of prehospital packed red blood cells (PRBCs), plasma, or transfusion of both products among trauma patients is unknown...

journals.lww.com

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Bryan Cotton

@bryanacotton1

4 years

Do. Not. “Protect” them. Take call (overnight, weekends). Get their “hands dirty.” A National Mixed-Methods Evaluation of Preparedness for General Surgery Residency and the Association With Resident Burnout | Medical Education and Training | JAMA Surgery

Evaluation of Preparedness for General Surgery Residency and Association With Resident Burnout

This cross-sectional mixed-methods study assesses preparedness for surgical residency, identifies factors associated with preparedness, examines the association between preparedness and burnout, and...

jamanetwork.com

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Bryan Cotton

@bryanacotton1

5 years

Can we stop delaying prophylaxis dosed LMWH/heparin in solid organ injuries? If it bleeds from such a small dose anti-coagulant, you need to be in the OR (or IR)

Eric Ley

@EricLeyMD

5 years

#WTA2019 Paper 28. Dr. Skarupa used TQIP data to establish that early VTE prophy in patients with nonop blunt solid organ injury was associated with reduced rates of VTE. VTE prophy did not lead to failure NOM or bleeding. Enoxaparin associated with lower rates compared to HSQ

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Bryan Cotton

@bryanacotton1

4 years

0300 labs, 0400 CXR, 💡 on all night. Need 2 rethink ICU environment, esp TBI. Move labs/CXR >2300? Turn off 💡 at night. Sleep Rx. Make day, day & night, night. Sleep Disruption Exacerbates and Prolongs the Inflammatory Response to Traumatic Brain Injury

Sleep Disruption Exacerbates and Prolongs the Inflammatory Response to Traumatic Brain Injury |...

Traumatic brain injury (TBI) alters stress responses, which may influence neuroinflammation and behavioral outcome. Sleep disruption (SD) is an understudied post-injury environmental stressor that...

www.liebertpub.com

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Bryan Cotton

@bryanacotton1

4 years

As w/Trauma, contrast doesn’t cause AKI. If pt in shock (hypo, septic, etc), THAT is what’s causing AKI. Perioperative contrast administration & incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study

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Bryan Cotton

@bryanacotton1

3 years

Scoop. And. Run. My fellowship alma mater found that despite being more severely injured, GSWs did just as well by police transport and were more likely to arrive with vitals. Arriving with vitals is always a nice place to start. 😬

Association of Police Transport With Survival Among Patients With Penetrating Trauma

This cohort study assesses mortality among patients with penetrating trauma who are transported to trauma centers by police vs emergency medical services in Philadelphia, Pennsylvania.

jamanetwork.com

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Bryan Cotton

@bryanacotton1

4 years

So USMLE Step 1 is going pass/fail?!?! The student that rocks it and puts the time in to master the date and get the best they can will now get the same score “P” as someone who barely passes?!?! Well, WE definitely failed...🤦‍♂️🤦‍♂️🤦‍♂️ #EverybodyGetsATrophy

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Bryan Cotton

@bryanacotton1

4 years

Busiest trauma center in US just got some brand new space! Ladies and Gentleman, I present to you the new Red Duke Trauma Institute @memorialhermann new Sarofim Tower!!! Thanks to TMD @MichelleKMcNutt for the incredible work in making the move happen this weekend! 🏥🤠🏥🤠

Michelle McNutt

@MichelleKMcNutt

4 years

@CJWray01 @memorialhermann @UTHealthACS @UTHealthSurg @UTHealth I agree. Beautiful building with state of the art equipment in all patient care areas including a dedicated trauma hybrid OR for the busiest trauma center in Texas will revolutionize care in Houston for trauma and all critically ill patients.

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Bryan Cotton

@bryanacotton1

6 years

Hat tip to @MidwinterMJ

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Bryan Cotton

@bryanacotton1

2 years

Lost this legend 7 years ago today. I talk about or quote this man almost every day. Beyond the logo on our coats & jackets, beyond the boots at the end of every bed in every trauma room, this man left a legacy that is a part of every faculty, trainee, & alumnus of this program

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Bryan Cotton

@bryanacotton1

4 years

Pregnant women with acute cholecystitis who have cholecystectomy deferred to postpartum have increased maternal-fetal complications (OR 3.0) &30-day readmissions (OR 1.61). Is It Safe to Manage Acute Cholecystitis Nonoperatively... : Annals of Surgery

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Bryan Cotton

@bryanacotton1

4 years

Finished off last night in old 🏥 w/ incredible case, 3 services operating simultaneously on patient in extremis. The @memorialhermann scrub team & nursing staff were flawless as always. No better place on the planet when you’re bleeding to 💀. Now on 2 the new 🏥! @UTHealthACS

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Bryan Cotton

@bryanacotton1

2 years

Congrats to this girl on her first day of medical school! So proud of you @MaddieCotton24 @McGovernMed

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Bryan Cotton

@bryanacotton1

4 years

Hard to know what to believe these days, but after convalescent plasma transfusion: temp ⬇️, SOFA ⬇️, P/F ⬆️, Viral loads ⬇️, ARDS resolved, and 3/5 patients D/Cd, other 2 stable. Treatment of Critically Ill Patients With COVID-19 With Convalescent Plasma

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Bryan Cotton

@bryanacotton1

4 years

Another AORN recommendation/mandate goes down...disposable jackets do not ⬇️ SSIs. Association of Disposable Perioperative Jackets With Surgical Site Infections in a Large Multicenter Health Care Organization | Surgery | JAMA Surgery | JAMA Network

Association of Disposable Perioperative Jackets With Surgical Site Infections

This cohort study of patients undergoing clean surgical procedures assesses whether use of perioperative disposable jackets is associated with the incidence of surgical site infections.

jamanetwork.com

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Bryan Cotton

@bryanacotton1

5 years

When my co-fellows @PennTrauma showed me their TRAUMA text signed by @kmattox1 Feliciano, and Gene Moore, I decided to get the WHOLE book signed! Well, not quite there, but I’m still tryin! @elliotthaut @goscar @UTHealthACS

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Bryan Cotton

@bryanacotton1

4 years

No diff in time to 🔪 for emergent trauma cases, but ⬆️⬆️ post-intubation arrest if done in ER/ED. 🎤⬇️...and Go Twitter! 🍿🍿🍿Emergency Department Versus Operating Suite Intubation in Operative Trauma Patients: Does Location Matter? | SpringerLink

Emergency Department Versus Operating Suite Intubation in Operative Trauma Patients: Does Location...

World Journal of Surgery - Decreasing the time from patient arrival to definitive surgical care in injured patients requiring an operation improves outcomes. We sought to study the effect of...

link.springer.com

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Bryan Cotton

@bryanacotton1

4 years

If you aren’t watching the AAST pro/con debates, you are missing out!!! TXA, REBOA, pre-peritoneal packing, GSWs to the CT scanner, and more! @traumadoctors @UTHealthACS @goscar @DrJtrauma @Jjasonsperrymd @JJcolemanMD @TopKniFe_B @bulgercot

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Bryan Cotton

@bryanacotton1

1 year

These are not the same patients. Not even close. And I'm a fan of propensity adjustments/analyses. Zone 1 REBOA vs Resuscitative Thoracotomy for Patient Resuscitation After Severe Hemorrhagic Shock via @JAMASurgery part of @JAMANetwork

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Bryan Cotton

@bryanacotton1

7 years

Ahhhh...Twitter. Where those without training, experience, and expertise in areas can challenge, argue and talk down to those with them...

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Bryan Cotton

@bryanacotton1

4 years

Bill Riordan was only fellow to stay around for 2nd yr, my 1st yr @VUMCTrauma Faculty. At end of 2nd yr, gave him bottle of Lagavulin 16 and pic attached with handwritten “Man in the Arena”speech. Started giving to all fellows here. Been a long 9yrs. 🌎 was better w/ you in it 👊

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Bryan Cotton

@bryanacotton1

3 years

When it’s only 10pm on a Wednesday and you’re BACK-UP and already had to change scrubs and hose down your boots in the shower…it’s gonna be one of those nights…🤦‍♂️

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Bryan Cotton

@bryanacotton1

1 year

yOu cAnT giVe kEtaMiNe tO hEaD InJuRiEs… Yeah, actually you can. In fact, it might REDUCE ICPs in select populations. Acute Effects of Ketamine on Intracranial Pressure in Childr... : Critical Care Medicine

Acute Effects of Ketamine on Intracranial Pressure in... : Critical Care Medicine

retrospective observational study, patients received bolus doses of ketamine for sedation or as a treatment for ICP crisis (ICP > 20 mm Hg for > 5 min). Administration times were synchronized with...

journals.lww.com

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Bryan Cotton

@bryanacotton1

5 years

Nope. Nope. And nope. Two words: (1) SCOOP and (2) RUN. Stay and play can cause more harm than good, at least in trauma; probably responsible for some of the results in this study from @UTHealthACS fellow @m_wandling (thanks 2 @PMHTrauma_ALE 4 sharing)

H Abraham

@DrHeidiAbraham

5 years

SADS - Sudden Ambulance Death Syndrome - critically ill patients who deteriorate quickly in the back of or on the way to the ambulance. Stabilize. Your. Patient. On. Scene. Before. You. Move. Them. #TxNAEMSP19 @veervithalaniMD

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Bryan Cotton

@bryanacotton1

5 years

“Scientific conclusions should not be based on whether a P value passes a specific threshold.” Word. Up. @johnaharvin @UTHealthACS

Ken Rothman

@ken_rothman

7 years

JAMA rejected this letter from my colleagues & me ("low priority"), so we're publishing on twitter, hoping JAMA will take it more seriously.

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Bryan Cotton

@bryanacotton1

3 months

Got 2 see this rockstar’s 1st meeting presentation in person on her work identifying endothelial genotypes of patients at risk of sepsis/other complications after trauma. Got 2 share ☕️ before she went 2 study. Proud of you @MaddieCotton24 @McGovernMed @UTHealthACS @JCCardenas52

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Bryan Cotton

@bryanacotton1

4 years

“Increasingly...clinicians hide behind the words ‘I’m not comfortable’ during challenging situations...which means I don’t wanna deal with this...should be someone else’s problem not mine.” Scudder Oration Trauma: I’m Not Comfortable with This via @YouTube

NL07: Scudder Oration on Trauma: I’m Not Comfortable with This

Dr. Gregory Jurkovich discusses the dangers of hiding behind discomfort and other themes from his Scudder Oration on Trauma with Dr. Naveen Sangji.Watch the ...

www.youtube.com

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Bryan Cotton

@bryanacotton1

4 years

When you’re so spoiled with direct flights out of Houston, that rather than fly to Chicago then Roanoke then drive for an hour an half, you fly to Nashville and drive to Hot Springs for Southern Surgical with your boy! @goscar

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Bryan Cotton

@bryanacotton1

6 years

Yep. It’s only hard if you make it. SAFD medics now doing blood transfusions in ambulances, saving lives with whole blood

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Bryan Cotton

@bryanacotton1

4 years

Even in Acute MI, don’t need Hb>10. Restrictive (7-8) vs. liberal (10-11)...💀5.6 vs. 7.7%, Recurrent MI: 2.1 vs. 3.1%, Infx: 0 vs. 1.5%: ALI: 0.3 vs. 2.2% Randomized Trial of Transfusion Strategies in Patients With Myocardial Infarction and Anemia

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Bryan Cotton

@bryanacotton1

2 years

Me and @m_wandling supersonic in the RS5 on our way to Austin. Looking forward to @EAST_TRAUMA presenting our new work, and seeing former fellows and colleagues. @ryanlawlessmd @johnaharvin @joyofmedicine

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Bryan Cotton

@bryanacotton1

6 years

BREAKING NEWS: Emotional intelligence & personality factors do NOT predict success in surgical residency. Situational judgement dominates predictive model. ( #1 factor I look at 4 fellows!) Evaluation of Screening Tools to Identify Successful Residents

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Bryan Cotton

@bryanacotton1

2 years

BREAKING NEWS: Whole blood is good when you are bleeding...whole blood. Congrats to @drjphazelton on a fantastic paper. Glad I got to see the presentation in person. 👊👊👊 Use of Cold-Stored Whole Blood is Associated With Improved... : Annals of Surgery

Use of Cold-Stored Whole Blood is Associated With Improved... : Annals of Surgery

d product of choice. We hypothesized that the use of WB versus BCT alone would result in decreased mortality. Methods: We performed a 14-center, prospective observational study of trauma patients who...

journals.lww.com

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Bryan Cotton

@bryanacotton1

4 years

You’d think the ONE thing they would require of you authoring a review article on a topic is that you spell it correctly. It’s “Thrombelastography” Thromboelastography-Guided Resuscitation of the Trauma Patient | Hematology | JAMA Surgery | JAMA Network

Thromboelastography-Guided Resuscitation of the Trauma Patient

This article reviews the ways in which thromboelastography assesses coagulation and examines its use in clinical decision-making.

jamanetwork.com

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Bryan Cotton

@bryanacotton1

2 years

💯 my change from zero research interest, to radically changing focus, to my on going research journey…😂 (Thanks to @elliotthaut for sharing)

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Bryan Cotton

@bryanacotton1

6 years

As previously stated re: Lancet study, “wait for it, wait for it, BOOM!” Absolute ⬇️ of 10% points in 30d 💀 for prehospital plasma in multicenter RCT. Also proved, again, 3-HR mortality should be primary outcome bleeding pts. 💪 work ⁦ @pitttrauma ⁩

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Bryan Cotton

@bryanacotton1

5 years

Got to meet up w/ this amazing man at TN-ACS today! John Tarpley (Long-time PD @VUMCSurgRes ) was instrumental in taking me under his wing, bringing me into the VA & allowing me to be SICU Director, and, along w/ Naji Abumrad, re-booting/saving my career after stumbling early on.

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Bryan Cotton

@bryanacotton1

4 years

13% ⬆️ 💀 rate for every 5% ⬇️ REM sleep. I can only imagine what these trauma night calls do with my REM... Association of Rapid Eye Movement Sleep With Mortality in Middle-aged and Older Adults | Neurology | JAMA Neurology | JAMA Network

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Bryan Cotton

@bryanacotton1

3 years

“You don’t practice till you get it right. You practice till you can’t get it wrong.” Welcome new fellows @aniamydy @UABSurgery , @MattLeatherman1 @USNavy , & @UNLVmedicine @usairforce Carter Kaminski to the Red Duke Trauma Institute @memorialhermann & @McGovernMed @UTHealthACS

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Bryan Cotton

@bryanacotton1

5 years

We don’t catch up. Period. While there’s no good solution 4 trauma call, likely ⬇️ our life spans. Ad lib Weekend Recovery Sleep Fails to Prevent Metabolic Dysregulation during a Repeating Pattern of Insufficient Sleep & Weekend Recovery Sleep

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Bryan Cotton

@bryanacotton1

2 years

Did you even train in Texas if you didn’t get a pair of boots for graduation and celebrate with big game heads on the wall?!?!

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Bryan Cotton

@bryanacotton1

4 years

Having an MD doesn’t make the prehospital delays to hospital any better. Every 10min ⬆️ inhospital 💀 by 9%. Association of Prehospital Time to In-Hospital Trauma Mortality in a Physician-Staffed Emergency Medicine System | Emergency Medicine | JAMA Surg

Association of Prehospital Time to In-Hospital Trauma Mortality in a Physician-Staffed Emergency...

This cohort study assesses the association of total prehospital time and in-hospital mortality in 2 prehospital, physician-staffed emergency medical systems in urban and rural France.

jamanetwork.com

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Bryan Cotton

@bryanacotton1

2 years

@SmashingPumpkin @Jack_Bass_ Absolutely amazing show. Brought me back to the early 90s when I saw them had a small club in Dallas before they blew up. Gish was perfect.

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Bryan Cotton

@bryanacotton1

7 years

@medicalaxioms Went 2 RNs at shift change on my 1st night on call in 1997 & said "I'm Bryan Cotton, I was waiting tables a week ago, I don't know shit!"

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Bryan Cotton

@bryanacotton1

5 years

“Severe shortages of skilled surgeons, especially trauma surgeons, on active duty and in the reserves.” We are happy to help keep their skills up!

Top Army Surgeon Blasts Military’s Capability to Handle War Traumas

The top trauma surgeon says the military is ill-equipped to handle battlefield casualties even in a limited war.

www.usnews.com

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Bryan Cotton

@bryanacotton1

5 years

You want to know how you give less blood products, give the best you got as soon as possible. WB. Plasma. Whatever. MTPs have shown ⬇️💀and ⬇️bloodproduct use by getting them to the patient earlier. 🚁🚑

Jeannie Callum

@JeannieCallum

5 years

@dfaraoni @UCL_ANESTH @EACTA @PedsCardiacAnes @ALNanesthesia With transfusion studies the result is almost always LESS is better for our patients! We need to focus our #PBM efforts on plasma as well as red cells!

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Bryan Cotton

@bryanacotton1

2 years

Southern Surgical road trip #3 underway! Last time @goscar & I made this trip, he made me drive home in freakin blizzard in a crappy minivan cuz his headache was getting bad & his vision was fading (turned out his SDH was getting worse!). Not this time! Oh, #RollRide @TraumaDawg

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Bryan Cotton

@bryanacotton1

6 years

Your post-op bleeding is not from the ibuprofen...now be quiet and let me treat their pain. 2 pts w/post-op bleeds (epistaxis) placebo arm, zero (0) in 800mg ibuprofen arm. Thanks for sharing ⁦ @johnaharvin ⁩ ⁦ @UTHealthSurg ⁩ ⁦ @UTHealthACS ⁩

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Bryan Cotton

@bryanacotton1

1 year

If you are having to leave a patient’s abdomen open after trauma/emergency surgery, you need to be doing one of two things: (1) my current lazy way of 3%NaCl @30ml /hr in place of maintenance IVF…or (2) DPR! To quote The Mandalorian #ThisIsTheWay @DrJtrauma @UofLDeptofSurg

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Bryan Cotton

@bryanacotton1

9 months

Congrats and Welcome to the 2024-2026 ACS/SCC Fellow class of @UTHealthACS @McGovernMed and the Red Duke Trauma Institute @memorialhermann !!! @WendyRockne from UC-Irvine @JOurieff from Mt. Sinai (Chicago) @BRamsuchitMD from Orlando Health #BigT #NoSONOS

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Bryan Cotton

@bryanacotton1

5 years

The importance of music in the OR. At least when we start closing. Prospective Randomized Study of the Effect of Music on the Efficiency of Surgical Closures | Aesthetic Surgery Journal | Oxford Academic

Prospective Randomized Study of the Effect of Music on the Efficiency of Surgical Closures

AbstractBackground. Music is commonly played in operating theaters. Some surgeons believe music reduces stress and operative time, while others think music

academic.oup.com

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Bryan Cotton

@bryanacotton1

4 years

Make DAY, DAY and NIGHT, NIGHT. Fentanyl, midazolam, propofol use lower in the LIGHT group, as were anti-psychotics and hallucinations. Impact of Natural Light Exposure on Delirium Burden in Adult Patients Receiving Invasive Mechanical Ventilation in …

Impact of natural light exposure on delirium burden in adult patients receiving invasive mechanical...

Admission to a single room with potential exposure to natural light via windows was not associated with reduced delirium burden, as compared to admission to a single room without windows. However,...

pubmed.ncbi.nlm.nih.gov

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Bryan Cotton

@bryanacotton1

4 years

Prehospital whole blood...under fire...🎤🕳...Ranger medics save lives in Afghanistan with blood transfusions while under fire

Ranger medics save lives in Afghanistan with blood transfusions while under fire

Two Army Rangers are alive today thanks to a program that is changing the way blood transfusions are done in combat.

www.stripes.com

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Bryan Cotton

@bryanacotton1

7 years

Dear AORN,

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Bryan Cotton

@bryanacotton1

5 years

“..scientific evidence fails to demonstrate any association between surgical hat type or extent of ear and hair coverage & SSI rates.” Proceedings and recommendations from the OR attire summit: A collaborative model for guideline development | The Bulletin

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Bryan Cotton

@bryanacotton1

3 years

Ho. Lee. Crap. This is amazing

Dr. Glaucomflecken

@DGlaucomflecken

3 years

Faculty meeting

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Bryan Cotton

@bryanacotton1

2 years

Did pilot green plasma study after seeing it in 🗑 at local blood center (below). Several journals rejected, finally accepted. Tried to do larger study, NIH and AABB rejected proposals cuz fEmALe pLaSmA bAd. Glad to see there are 2 podiums on female plasma/cryo at AAST 2022!

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Bryan Cotton

@bryanacotton1

2 years

When COVID screws up your Fellow’s Graduation Boot gifts (handmade in Mexico), you make your former fellow fly all the way from Hawaii to pick them up at the southern Surgical…and make him close the discussion! 😬 @goscar @drjonsimmons @LillianKao1 @UTHealthACS

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Bryan Cotton

@bryanacotton1

7 years

Surgical Caps Get Clean Bill of Health - Looking forward to full manuscript addressing non-evidence based AORN rules

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Bryan Cotton

@bryanacotton1

5 years

They concluded we should restrict transfusions in OB hemx because of immunosuppression. You know who doesn’t have immunosuppression? Dead people. Also try to word paper like it’s an RCT. It wasn’t. Women who got blood sicker, older, more diff delivery.

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Bryan Cotton

@bryanacotton1

6 years

My hometown here busting out the whole blood on ground crews! Our group has worked with these guys and they are top notch. They rolled this out quicker than we did! Less red tape and blood Bank hand-wringing...😂. Keep up the good work guys!

How blood transfusions delivered by emergency responders could change lives

Major car accidents, gunshots and even childbirth can all be times when someone may require a blood transfusion.

www.click2houston.com

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Bryan Cotton

@bryanacotton1

5 years

Congratulations to our incoming #BigT #NoSONOS Trauma/SCC fellows to the Red Duke Trauma Institute @UTHealthACS @UTHealthSurg @McGovernMed . On behalf of the University of Texas Health Science Center in Houston, welcome @dev_rushabh @KMMueck and @pitttrauma John Griepentrog!!!

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Bryan Cotton

@bryanacotton1

6 years

Yes!!! ‘Bout time. Now waiting for civilian approval. Not to sound dramatic, but will be a game changer for prehospital resus and less busy EDs.

The FDA has approved the use of this potential life saver for troops on the battlefield

The Food and Drug Administration has approved freeze-dried blood plasma to be used on the battlefield to treat wounded U.S. troops.

www.militarytimes.com

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Bryan Cotton

@bryanacotton1

6 years

No new findings here. ➕fluid balance by 48-72hrs >⬆️💀, ➖balance (active or passive)>⬇️💀 However, new to me at least, the term Deresuscitation! ❤️ it! Should be less offensive than my current use of “un-f$& @ing things”

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Bryan Cotton

@bryanacotton1

2 years

Scoop. And. Run. If you can help the patient en route with hemorrhage control, airway issues, etc, by all means do. But do it on the way.

Carlos Yanez MD, MSc, FACS

@CarlosYanezCiru

2 years

Police transport of penetrating trauma patients in urban locations results in similar outcomes compared with ALS. Immediate transport to definitive trauma care should be emphasized in this patient population. @StcuaeC @estesonline @NGTriageEU @traumadoctors @JTraumAcuteSurg

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Bryan Cotton

@bryanacotton1

3 years

This dude is just amazing

Dr. Glaucomflecken

@DGlaucomflecken

3 years

Surgery has an add-on

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Bryan Cotton

@bryanacotton1

5 years

@SirGinnn That’s awesome!!! I did fellowship, then 1st job at places that rejected me from med school+residency. Now have a job at place that ALSO rejected me for both. Now get to teach/train students+residents there! That said, I was rejected from every medschool in the 🇺🇸...twice...😬😬

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Bryan Cotton

@bryanacotton1

1 year

BREAKING NEWS: Non-con abdominal CTs for abdominal pain...are still crap Diagnostic Accuracy of Unenhanced CT for Evaluation of Acute Abdominal Pain in the Emergency Department via @JAMASurgery part of @JAMANetwork

Diagnostic Accuracy of Unenhanced CT for Evaluation of Acute Abdominal Pain in the Emergency...

This study attempts to determine the diagnostic accuracy of unenhanced abdominopelvic computed tomography using contemporaneous contrast-enhanced computed tomography as the reference standard in...

jamanetwork.com

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Bryan Cotton

@bryanacotton1

4 years

All the time! In the bar, out of the bar, across the street...😬 #HandSewEverything @shane_jensen19 @EthanATaub @m_wandling . @cameronmccoy @kjkwinger6 @mouayyadz @joyofmedicine @georgoff @Bill_bec @JMcCauleyMD @UTHealthACS

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Bryan Cotton

@bryanacotton1

4 years

Was told during early battles as young faculty that ⬇️ crystalloids was 4 penetrating injury & even if I spared them an open abdomen, I would harm kidneys. Nothing could be more wrong. Fluid Balance and Association with Post-Traumatic Acute Kidney Injury

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Bryan Cotton

@bryanacotton1

6 years

What the what?!?!? 😳...send me some of that to study UBC! 🇨🇦🇨🇦🇨🇦.

Canadian researchers find a way to turn Type A and B blood into Type O | Globalnews.ca

Researchers at UBC have used enzymes from the human gut to change Type A and B blood into the more sought-after Type O.

globalnews.ca

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Bryan Cotton

@bryanacotton1

2 years

My boss is cooler than yours. Strong work @LillianKao1

American College of Surgeons

@AmCollSurgeons

2 years

We have several new officers in our Board of Governors Executive Committee - congratulations to them all as they assume their roles! #ACSCC22

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Bryan Cotton

@bryanacotton1

2 years

Welcome my friend @ZielinskiTrauma to Houston the only way I know how! With amazing Indian food and a ridiculous bourbon collection. Can’t wait to see the great things you do next door and look forward to amazing collaborations!!! @UTHealthACS

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Bryan Cotton

@bryanacotton1

4 years

Two level-1s covering the 4th largest city in the US and a HUGE swath of land. It's also true how close we are to each other...we share a parking garage...😂 Describing the density of high-level trauma centers in the 15 largest US cities

Describing the density of high-level trauma centers in the 15 largest US cities

Background There has been a proliferation of urban high-level trauma centers. The aim of this study was to describe the density of high-level adult trauma centers in the 15 largest cities in the USA...

tsaco.bmj.com

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Bryan Cotton

@bryanacotton1

3 years

Been doing this for a while with trauma ex laps. Looks like I will continue for now. Prophylactic Single-use Negative Pressure Dressing in... : Annals of Surgery

Prophylactic Single-use Negative Pressure Dressing in... : Annals of Surgery

the length of stay. Background: The sNPWT dressings have been associated to several advantages like cost savings and prevention of SSOs like seroma, hematoma, dehiscence, or wound infection (SSI) in...

journals.lww.com

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Bryan Cotton

@bryanacotton1

5 years

@elliotthaut @MarkSeamonMD @fourmiracles101 @EAST_TRAUMA @JosephSakran @goscar @JJcolemanMD I lost over 2 days of my life arguing against prehospital clamshell even among Physicians (not Surgeons) on Twitter...now it’s being suggested in non-physicians?!?!I’m not biting on this. You guys argue and take this one.

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Bryan Cotton

@bryanacotton1

4 years

While “patients who are not resuscitated should not receive EN until stabilized...many studies show outcome benefit of early EN in patients receiving vasopressors” Enteral Nutrition Can Be Given to Patients on Vasopressors : Critical Care Medicine

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Bryan Cotton

@bryanacotton1

4 years

As in CRASH-2, TXA does NOT benefit all pts, only those in profound shock (SBP<70) & <1h from injury. CRASH-2 found only penetrating as well. DB, RCT of Tranexamic Acid During Prehospital Transport in Patients at Risk for Hemorrhage After Injury

Tranexamic Acid During Prehospital Transport in Patients at Risk for Hemorrhage After Injury

This randomized clinical trial assesses the effectiveness and safety of tranexamic acid administered before hospitalization compared with placebo in injured patients at risk for hemorrhage.

jamanetwork.com

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Bryan Cotton

@bryanacotton1

6 years

Yep. Whole. Blood. That is all...

Journal of Trauma and Acute Care Surgery

@JTraumAcuteSurg

6 years

Whole Blood Mitigates the Acute Coagulopathy of Trauma and Avoids the Coagulopathy of Crystalloid Resuscitation. #TraumaSurg

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Bryan Cotton

@bryanacotton1

6 years

My colleague, my good friend, and one of a handful of people that I will call for advice in the middle of the night (and he answers!). Thanks for coming for Grand Rounds! @goscar @UTHealthSurg @UTHealthACS

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Bryan Cotton

@bryanacotton1

1 year

Jen Gurney and JTS group dropping the 🎤 on futility by transfusion volumes at #WTA2023 Hint: there is none. And the survivors at extremes got…whole…blood

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Bryan Cotton

@bryanacotton1

2 years

Another study supporting WB over component therapy presented beautifully by @drjphazelton 14-center study from EAST collaboration Let’s go blood providers! #MyBloodResusIsBetterThanYours

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Bryan Cotton

@bryanacotton1

4 years

If you have a 🔪...only one answer. Upstairs NOW, prep/drape awake, hear the saw fire, intubate and cut at same time.

Christian de Virgilio MD FACS

@drdevirgilio

4 years

Young adult w/ stab wound to left chest just below nipple, combative, tachypneic, breath sounds =, BP 80/60, HR 110, bedside CXR (-); ultrasound (+) pericardial fluid. Next step? #MedStudentTwitter #surged #MedTwitter

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Bryan Cotton

@bryanacotton1

2 years

Nice, honest paper on PH resus thor. Zero survived to D/C. That is all… 6-year case series of resuscitative thoracotomies performed by a helicopter emergency medical service in a mixed urban and rural area with a comparison of blunt vs penetrating trauma

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Bryan Cotton

@bryanacotton1

1 year

Critical lecture in 3…2… @TopKniFe_B

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Bryan Cotton

@bryanacotton1

4 years

More serious errors with shorter shifts. ⁦ @UTHealthACS ⁩ Effect on Patient Safety of a Resident Physician Schedule without 24-Hour Shifts | NEJM

Effect on Patient Safety of a Resident Physician Schedule without 24-Hour Shifts | NEJM

The effects on patient safety of eliminating extended-duration work shifts for resident physicians remain controversial. We conducted a multicenter, cluster-randomized, crossover trial comparing tw...

www.nejm.org

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Bryan Cotton

@bryanacotton1

2 years

@CarlosYanezCiru @aecirujanos @traumadoctors @JTraumAcuteSurg @AlbertoEstevesC You know what high-grade splenic injuries don’t develop delayed pseudoaneurysm?

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Bryan Cotton

@bryanacotton1

7 years

Every minute counts: Time to delivery of initial massive... : Journal of Trauma and Acute Care Surgery

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Bryan Cotton

@bryanacotton1

2 years

Trauma Team Mental Health Night! Red Duke Trauma Team representin’ at Smashing Pumpkins!!! 🔨 🎃 @KMMueck

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Bryan Cotton

@bryanacotton1

4 years

Been said before: scoop and run & diesel for penetrating, plasma/WB for longer times and blunt. Association of Prehospital Plasma Transfusion With Survival in Trauma Patients With Hemorrhagic Shock When Transport Times Are Longer Than 20 Minutes

Association of Prehospital Plasma Transfusion With Mortality in Trauma Patients

This post hoc analysis uses data from the Control of Major Bleeding After Trauma and the Prehospital Air Medical Plasma clinical trials to examine whether prehospital plasma transfusion is associated...

jamanetwork.com

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