Day 1 :
Keynote Forum
Yasumitsu Mizobata
PROFESSOR
Keynote: Teamwork training for the trauma surgery
Time : 09.15-10.00
Biography:
Professor Mizobata has graduated Osaka City University on 1985, and completed his PhD from Osaka University. He finished his trauma surgery training in Osaka University Hospital and Senshu Critical Care Medical Center. He is the professor of department of traumatology and critical care medicine in Osaka City University. He is the board member of the JAAM, JAST, JSACS, and JSEM
Abstract:
It is important to start the resuscitative procedure as quick as possible in the massive hemorrhagic trauma patients. In addition to prepare all resources for the resuscitative surgery, high quality team performance is essential to achieve the good outcome. Recently teamwork training courses for the trauma surgery are provided.
Advanced trauma operative management (ATOM) started on 2008 in Japan. Recently we produced ATOM nurse course. The course contains didactic lecture for thoracic and abdominal injury, in which the instruments and procedures of the trauma surgery are introduced and how to be prepared in the operative theatre. Both the surgeons and the nurses join the teamwork lecture to learn about the team building, leadership, and communication. In the animal lab, they will communicate about the awared situation and decision for the surgical strategy. In the survey to the nurses who participated in the course, high score of satisfaction was observed.
In our institute, teamwork training for the trauma surgeons and nurses started. The course teaches non-technical skills for acute medicine, and named as NoTAM. After the implementation of these training, the time since arrival to the operation and the time of the operation were significantly shorter as compared to those in the period of pre-implementation. The standardized mortality ratio tended to decrease from 85% to 77%.
In conclusion, the resuscitation for the trauma patient should be started quickly. High level of the teamwork as well as the preparation of all resources for the resuscitation and operation is required. Teamwork training may improve the quality of trauma care and the outcome of the injured patients
Keynote Forum
Dr David Andrew YEUNG
DOCTOR
Keynote: Tech 4X40-40: A No-Pump Technique to Save possibly 1 million Trauma Patients yearly
Time : 10.00-10.45
Biography:
In 1985-1988 at the King FAHD Hospital in Jeddah, I discovered the indepth secrets of 60 million patients dying prematurely yearly worldwide and I wrote the Blue Thesis on "Controlled Hibernation" to save at least 50 million of these patients.After 24 years research work I obtained the prestigious St Jerome Prize - Budapest in May 2004 and the Bronze Prize - Kuala Lumpur in May 2005 for H2O2 Artificial Lung System("HALS").
Abstract:
Yearly 3 million persons die out of Hospitals from Trauma despite advanced CPR using Oâ‚‚ Gas at 37 °C.
Tech 4X40-40 will use, alternatively the Artificial Blood AB, a new preserving solution containing the requisite amount of Oâ‚‚ at 10 °C.
Two related Poster Presentations were made:
APSC 2017 -Singapore: ECHO the Possible Alternative to ECMO for Heart Failure Patients - mentioning Tech 4X40 briefly in my presentation.
TTS 2018 - Madrid: Tech 4x40-40: A No-Pump Technique For Transplantation Preservation Procedures.
Bigelow in 1950s and Gibbon in 1960s laid down the basis of Hypothermia and concluded that at 15 °C the Metabolism is reduced to 1/7.
By extrapolation it is ≈ 1/15 at 10 °C resulting in consequential reduction in Oâ‚‚ requirement.
The following new life-saving technique Tech 4X40-40 is herein proposed:
The helplessly and inexorably dying (after, if need be, induced circulatory arrest, anesthetic or muscle paralysis to prevent increasing Oâ‚‚ Debt) or cardiac-arrest Trauma patient, out of Hospital, is immersed in circulating water at 4 °C.
This is Tech 4 which buys time of 45 minutes; the core-temperature will dropped to about 27 °C at the 45th minute. Within 45 minutes a Femoral Artery Catheter is inserted and a slit is made in the femoral vein.
100 liters of the AB are infused in 15 hours following specific modalities without using a pump, at a Pressure of 40 mm Hg (Neurons die at 50 mm Hg if there is Intra-cerebral bleeding) in such a way that the Oâ‚‚ debt of the patient is paid within 2 minutes and the Oâ‚‚ requirement is satisfied thereafter.
This is Tech 4x40 which will buy time of 15 hours, allowing transfer of the patients to the Hospitals.
In the Hospitals, further infusion of the AB at 4 liters/hour is undertaken for 40 days = Tech 4X40-40
At this stage, after this Optimum life preserving technique, this will result in 2 groups of patients:
(1)Survivors – with whatever intracranial bleeding stopped -possibly 1 million yearly.
(2) Brain Death Patients - possibly 1 million of Potential Donors of organs yearly.
Keynote Forum
Francesca Giovannini
PROFESSOR
Keynote: Traumatological application of 3D printed model of injuried pelvis: a case report
Time : 10.45-11.30
Biography:
Francesca completed her D.Phil at Oxford University (2009-2012) in the Department of Politics and ternational Relations with a thesis that explores the role of regional powers in designing and influencing regional nuclear policies. She was 2012-2013 postdoctoral fellow at CISAC, and became a CISAC affiliate in September 2013.
Abstract:
Introduction: Three-dimensional (3D) reconstruction and rapid prototyping, starting from computed tomography (CT), are promising technologies that can facilitate preoperative programming and intraoperative implementation, thus obtaining better results in complex fractures. Moreover, it is possible not only to simulate CAD reductions but also to design customized plates. In the case that we treated, a plate was made of two pieces (like a puzzle-plate) in order to be able to position a first plate without removing the reduction instruments and the second plate after the partial synthesis obtained to complete it.
Materials and Methods: We decided to use this method to increase the evaluation of the "personality of the lesion" and to obtain a custom synthesis tool made in a case of diastasis of the pubic symphysis.
Results: The solid model (3D printed model) allowed accurate preoperative planning, facilitating the surgical approach and the production of a custom-made plate.
Discussion: We reduced surgical time thanks to the perfect knowledge of the structure of the lesion, the reduction maneuvers and the presence of a custom-made plate. In addition, soft tissue damage, blood loss, risk of infection and use of ionizing radiation were reduced if compared to a case approached by the standard method.
Conclusions: The method described has been extremely useful in the surgical treatment of the diastasis of pubic symphysis.