Survey of American College of Surgeons Committee on trauma members on firearm injury: Consensus and opportunities.

BACKGROUND: In the United States, there is a perceived divide regarding the benefits and risks of firearm ownership. The American College of Surgeons Committee on Trauma Injury Prevention and Control Committee designed a survey to evaluate Committee on Trauma (COT) member attitudes about firearm ownership, freedom, responsibility, physician-patient freedom and policy, with the objective of using survey results to inform firearm injury prevention policy development. METHODS: A 32-question survey was sent to 254 current U.S. COT members by email using Qualtrics. SPSS was used for χ exact tests and nonparametric tests, with statistical significance being less than 0.05. RESULTS: Our response rate was 93%, 43% of COT members have firearm(s) in their home, 88% believe that the American College of Surgeons should give the highest or a high priority to reducing firearm-related injuries, 86% believe health care professionals should be allowed to counsel patients on firearms safety, 94% support federal funding for firearms injury prevention research. The COT participants were asked to provide their opinion on the American College of Surgeons initiating advocacy efforts and there was 90% or greater agreement on 7 of 15 and 80% or greater on 10 of 15 initiatives. CONCLUSION: The COT surgeons agree on: (1) the importance of formally addressing firearm injury prevention, (2) allowing federal funds to support research on firearms injury prevention, (3) retaining the ability of health care professionals to counsel patients on firearms-related injury prevention, and (4) the majority of policy initiatives targeted to reduce interpersonal violence and firearm injury. It is incumbent on trauma and injury prevention organizations to leverage these consensus-based results to initiate prevention, advocacy, and other efforts to decrease firearms injury and death. LEVEL OF EVIDENCE: Prognostic/epidemiologic study, level I; therapeutic care, level II.

PolyHeme: are we ready for a blood substitute?

Optimal management of hemorrhage requires control of the site of bleeding. Adjunctive to this control is resuscitation. The optimal resuscitation product remains elusive. From many standpoints, fresh, warm, whole blood would be considered the best option. For many reasons, such products are not universally available. One potential blood substitute, PolyHeme has recently completed a Phase III clinical trial. The scientific foundations for the use of the product are described in this review as are some of the preliminary results and controversies. Ultimately, the role of PolyHeme will depend in a great deal on review of the results of the current study.

Are trauma centers important? You bet your life!

Trauma centers and trauma systems are vital community assets. By aggregating resources and personnel dedicated to the care of the injured patient, they lower trauma morbidity and mortality. The trauma center is a key educational component of all members of the health care team. Complex and advanced medical care is coordinated in a fiscally responsible manner that facilitates and improves patient care and stimulates innovation. The threat of more domestic terrorism and mass casualties in the post 9-11 world has exponentially increased the need for, and responsibilities of, trauma systems. Healthy trauma centers are an indispensable component of a healthy community.