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In Canada, trauma patients often present initially to non-trauma hospitals without vascular surgeons on site. Local surgeons need skills and support for damage-control vascular surgery. Canadian training programs in general surgery should equip trainees with skills in this area, including resuscitation, identification of vascular injury, hemorrhage control, and temporizing measures (e.g., shunts, ligation). Caring for trauma patients is a multidisciplinary endeavour; understanding local/regional skill sets and from whom to seek help is vital. Opportunities for skills maintenance should also be encouraged for surgeons practising at sites where acutely injured patients present., The bleeding trauma patient requires urgent intervention to save their life. In Canada, our geography and health care resources often mean that hemorrhaging patients first present to non-trauma hospitals without [...]

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a well-described intervention for noncompressible torso hemorrhage. Several Canadian centres have included REBOA in their hemorrhagic shock protocols. However, REBOA has known complications and equipoise regarding its use persists. The Canadian Collaborative on Urgent Care Surgery (CANUCS) comprises surgeons who provide acute trauma care and leadership in Canada, with experience in REBOA implementation, use, education and research. Our goal is to provide evidence- and experience-based recommendations regarding institutional implementation of a REBOA program, including multidisciplinary educational programs, attention to device and care pathway logistics, and a robust quality assurance program. This will allow Canadian trauma centres to maximize patient benefits and minimize risks of this potentially life-saving technology., Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a well-described intervention for noncompressible torso hemorrhage. (1-4) International literature has described the indications, technique and outcomes of 7- to 12-French [...]

Multidisciplinary simulation has been used to successfully teach crisis resource management in operating room and emergency department settings. This article describes a 'Mega-Sim' approach using an in-situ simulation that moves among multiple hospital departments to enhance multidisciplinary training and assess institutional response to a rare but high-risk event: trauma in a pregnant patient. It appears that a Mega-Sim can be used to identify systems issues, increase medical knowledge and improve perceptions of teamwork and communication within and among hospital departments., All trauma systems consider trauma in pregnancy (TIP) to be a critical challenge. Successful outcomes for two lives depend on rapid, seamless integration of interventions from multidisciplinary teams along a [...]

While the positive uses for video games in an educational setting have also been established, the educational aim is usually made explicit. The goal of this research was to develop a video game wherein the educational aspect was implicitly embedded in the video game, such that the gameing activity remained interesting and relevant. Following a pilot study to confirm the usability of an in-house developed game, two studies were conducted with 11-17 year old hockey players ("N"[1]=130, "N"[2]=39). Results demonstrated that participants playing the experimental version of the video game scored significantly higher on a concussion symptoms questionnaire, in a significantly faster time, than participants playing the control version of the game. Most participants indicated that they enjoyed the game and would play it again. These results suggest that educational material can be conveyed successfully and in an appealing manner via video game play.

General surgeons provide life-saving trauma care to a large portion of Canadians. Although trauma care has evolved significantly over the last few decades and now requires fewer operations, when a life-saving operation is required the expectation of competence to perform this operation has not been reduced. A recent study from the United States found decreased resident case-log volumes of trauma operations. Such findings raise the alarm of declining exposure of residents to trauma operations and beg the question of whether graduating residents are competent to care for trauma patients. Examination of the Canadian setting reveals a dearth of published information about the actual exposure of Canadian general surgery residents to trauma care. With the forthcoming evolution of general surgery education into competency-based medical education, we sound a call to action to ensure that all graduating general surgeons are able to provide the care that both the Royal College of Physicians and Surgeons of Canada and the Canadian public demand., For decades, general surgeons have provided clinical care to many of the nearly 250 000 injured Canadians annually. Given both our geography (more than 7 million Canadians reside farther than [...]