Management of Chest Trauma

Adam M. Shiroff, MD, FACS Director, Penn Center for Chest Trauma Associate Professor of Surgery Perelman School of Medicine University of Pennsylvania Philadelphia, PA USA     Mark J. Seamon, MD. Director of Research, Director of Education Professor of Surgery Division of Traumatology, Surgical Critical Care & Emergency Surgery Perelman School of Medicine at the University of Pennsylvania     Lewis J. Kaplan, MD, FACS, FCCM, FCCP Professor of Surgery Perelman School of Medicine University of Pennsylvania Section Chief, Surgical Critical Care Medical Director, Surgical ICU Corporal Michael J Crescenz VAMC Philadelphia, PA USA   Dr. Shiroff is a trauma, critical are and emergency general surgeon at the Perelman School of Medicine at the University of Pennsylvania. He also serves as the Director of the Penn Center for Chest Trauma in Philadelphia, PA.  Dr. Shiroff gained his undergraduate degree in Biology and graduated with Honors from the University of Michigan in 1998. He obtained his medical degree at Jefferson Medical College (2002) and finishing residency in General Surgery at Christiana Care Health System (2007) in Newark, DE. Following this Dr. Shiroff was fellowship trained in Surgical Critical Care at Penn (2007) with an additional year of Trauma and Emergency Surgery training (2009). Following fellowship Dr. Shiroff joined the faculty at Rutger Health in New Brunswick, NJ and rose to Trauma Program Director then moving to Division Chief at Jersey Shore University Medical Center. In 2015 Dr. Shiroff was recruited back to Penn and established the Penn Center for Chest Trauma. Dr. Shiroff has become a internationally recognized expert in chest wall injury, is past president and board of directors member of the Chest Wall Injury Society, and see's patients from around the world with complex chest wall injuries. His interests follow this same vein and he has worked with industry partners in the development and testing of instruments, and the teaching of advanced chest wall surgery. He is an innovated in the area of minimally invasive chest wall surgery. Most recently Dr. Shiroff has completed his business degree from the Kenan-Flagler Business School at the University of North Carolina.   Dr. Seamon received his undergraduate from Wesleyan University, Middletown, Connecticut and received his medical degree from University of Pittsburgh School of Medicine. He completed his residency at Temple University Hospital, Philadelphia, Pennsylvania. Dr. Seamon also completed a Trauma and Surgical Critical Care Fellowship at the University of Pennsylvania, Philadelphia and is board certified in surgery and surgical critical care. As Penn Trauma faculty member, Dr. Seamon is interested in and well-published in the clinical management of complex penetrating injuries and outcomes from extreme injury.   Dr. Kaplan is a general, trauma and critical care surgeon at the Perelman School of Medicine at the University of Pennsylvania and also serves as the Section Chief of Surgical Critical Care at the Corporal Michael J Crescenz VA Medical Center in Philadelphia, PA.  Dr. Kaplan received his undergraduate BA from Franklin and Marshall College in Lancaster, PA (1984) and his MD from the Rutgers School of Medicine in Piscataway, NJ (1988).  General Surgery residency was completed at the Medical College of PA including a two-year cardiothoracic surgery research program (1988-1995).  He subsequently undertook a Fellowship in Surgical Critical Care at the University of Pittsburgh Medical Center (1996-1997) and then joined the faculty at MCP and Hahnemann University Hospital in Philadelphia, PA where he directed the SICU and the Surgical Critical Care (SCC) fellowship. Seven years later he was recruited to Yale University to establish an Emergency General Surgery service for the Division of Trauma and Surgical Critical Care.  He then assumed leadership in the Yale-New Haven Hospital ICU and the SCC and Acute Care Surgery fellowships.  After eleven years, he was recruited back to Philadelphia into his current roles. Dr. Kaplan serves in leadership positions in several professional societies and is a past-President of the Society of Critical Care Medicine (2020-2021).   He sits on multiple editorial boards including those of the Journal of Trauma and Acute Care Surgery, Critical Care Medicine, and Surgical Infections and reviews for a host of others.  A durable interest in Tactical Emergency Medical Services is underscored by serving as a surgeon embedded in a regional SWAT team.  Dr. Kaplan's clinical interests include acid-base physiology, mechanical ventilation, transfusion, surgical infections, sepsis, and acute kidney injury. 

1. Centers of Excellence, Trauma & Health Care Systems, and Regionalization.- 2. Introduction, Definitions, and Significance of Chest Trauma.- 3. The initial resuscitation of the chest trauma patient.- 4. Non-Operative Rib Fracture Management.- 5. Operative Rib Fracture Management.- 6. Flail chest.- 7. Costal Cartilage Injury.- 8. Management of Rib and Sternal Fracture Non-Unions.- 9. Sternal Fracture Repair.- 10. Clavicle and Scapula Fractures.- 11. Non-Surgical Aids in Fracture Healing.- 12. Anesthesia and Analgesia Options in Chest Wall Injury.- 13. Blunt Cardiac and Aortic Injuries.- 14. Penetrating Cardiac Injury.- 15. Penetrating Vascular Injuries of the Thorax.- 16. Esophageal Injuries.- 17. Tracheal and Pulmonary Injury.- 18. Transmediastinal and Thoracoabdominal Injuries. Damage Control and Surgical Techniques for their Management.- 19. Principles of ICU resuscitation and team-based care.- 20. Coagulopathy Management and VTE Prophylaxis.- 21. Monitoring Strategy for the Operating Room and Intensive Care Unit After Thoracic Injury.- 22. Mechanical Ventilation After Thoracic Injury.- 23. Respiratory Adjuncts.- 24. Lung Rescue and ECMO.- 25. Approaches to Analgesia After Chest Injury.- 26. The Role of Advanced Practice Providers (APPs) in the Intensive Care Unit (ICU) .- 27. Managing Conflict in the Surgical Intensive Care Unit.- 28. Pulmonary Infections.- 29. Blast Injury, Blast Lung, and Pulmonary Aspiration.- 30. Thoracic Crush Injury After Natural and Man-Made Disaster.- 31. Toxic Inhalations.- 32. The Local Facility Role in National Disaster Planning and the Ethics of Resource Allocation