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Department Of Anesthesiology
Department Of AnesthesiologyDivisionsTrauma Anesthesiology

Trauma Anesthesiology

The mission of the Division of Trauma Anesthesiology is to provide high quality, state of the art anesthetic care to patients at the R Adams Cowley Shock Trauma Center. The R Adams Cowley Shock Trauma Center is the world’s first free-standing trauma center that initially opened in the 1970’s. A new Shock Trauma Critical Care Tower opened in 2013 and allowed us to meet increasing patient volume demands by adding additional beds to our critical care units. The Trauma Center serves as a referral center for over 8,000 patients in and around Maryland. The goal is to be the leading trauma center in the world, practicing evidence-based medicine and serving as a model for other trauma centers. The trauma anesthesia department is an integral part of the team that helps patients return to functional lives after tragedy, and to make that transition as seamless and comfortable as possible. This state-of-the-art trauma facility also serves as a model for military teams that the Anesthesiology Department takes pride in training through the Center for Sustainment of Trauma and Readiness Skills (C-STARS) program.

In addition to managing acute traumas, the Division also provides anesthesia for a variety of surgeries that include soft tissue infections, plastic, reconstructive and maxillofacial surgeries and orthopedic surgeries. The Division uses a multimodal approach when caring for patients that encompasses regional anesthesia techniques and alternative pain management therapies through our integrative medicine discipline when appropriate.

Research

Members of the Trauma Anesthesia faculty have been widely published. For example, published research areas have focused on resuscitation, evaluation of non-anesthesia airway trainees and traumatic brain injuries. Faculty are currently involved in a variety of projects such as assessing non-invasive monitors to assist pre-hospital providers with triage decisions or interdepartmental studies investigating oxygen concentration and outcomes in orthopedic patients. We are currently participating in a multicenter prospective trial using circulatory arrest and deep hypothermia to facilitate timely surgical repair in patients who have sustained life threatening penetrating trauma. Yvette Fouche, MD, is collaborating with Sarah Murthi, MD, Department of Surgery, on the opioid prescribing practices for trauma patients. The goal of this study is to reduce opioid dependency in trauma patients both acutely and post discharge.

Recent Publications

  1. Verdiner RE, Choukalas CG, Siddiqui S, Stahl D, Galvagno S, et al. COVID-Activated Emergency Scaling of Anesthesiology Responsibilities Intensive Care Unit. Anesth Analg. 2020;131(2):365-377. PMID:32398432.
  2. Galvagno, S M. Jr.; Sikorski, RA.; Floccare, D J.; Rock, P; Mazzeffi, M A.; DuBose, J J.; Scalea, T M.; Miller, C; Richards, J E.; O’Connor, JV.; Mackenzie, C F.; Hu, PPrehospital Point of Care Testing for the Early Detection of Shock and Prediction of Lifesaving Interventions, SHOCK: December 2020 - Volume 54 - Issue 6 - p 710-716 doi: 10.1097/SHK.0000000000001567.PMID: 32453248.
  3. Jones KM, DiChiacchio L, Deatrick KB, Dolly K, Rea J, Galvagno S, Herr D, O’Connor J, Scalea T, Menaker J. Cardiac Arrest Prior to Initiation of Veno-Venous Extracorporeal Membrane Oxygenation Is Not Associated with Increased In-Hospital Mortality. ASAIO J. 2020;66(6):e79-e81. PMID:32479713.
  4. Deatrick KB, Mazzeffi MA, Galvagno SM Jr, Boswell K, Kaczoroswki DJ, Rabinowitz RP, Madathil RJ, Cornachione CR, Herr DL, Scalea TM, Menaker J. Breathing Life Back Into the Kidney-Continuous Renal Replacement Therapy and Veno-Venous Extracorporeal Membrane Oxygenation. ASAIO J. 2021 Feb 1;67(2):208-212. doi: 10.1097/MAT.0000000000001210. PMID: 32657829.
  5. Sanford Z, Madathil RJ, Deatrick KB, Tabatabai A, Menaker J, Galvagno SM, Mazzeffi MA, Rabin J, Ghoreishi M, Rector R, Herr Dl, Kaczorowski DJ. Extracorporeal Membrane Oxygenation for COVID-19. Innovations. 2020;15(4):306-313. PMID:32692258.
  6. Kelley KM, Bittle G, Scalea TM, Kaczorowski D, Galvagno S, Menaker J, Lauerman M.. Cannulation for Venovenous Extracorporeal Membrane Oxygenation After Ligation of the Inferior Vena Cava in a Blunt Trauma Patient. Am Surg. 2020;86(11):1582-1583. PMID:32755386.
  7. Mazzeffi M, Bathula A, Tabatabai A, Menaker J, Kaczorowski D, Madathil R, Galvagno S, Pasriga C, Rector R, Tanaka K, Herr D. Von Willebrand Factor Concentrate Administration for Acquired Von Willebrand Syndrome- Related Bleeding During Adult Extracorporeal Membrane Oxygenation. J Cardiothorac Vasc Anesth. July 2020. PMID:32758410.
  8. Morris NA, Patel N, Galvagno SM Jr, et al. The effect of platelet transfusion on functional independence and mortality after antiplatelet therapy associated spontaneous intracerebral hemorrhage: A systematic review and meta-analysis. J Neurol Sci. 2020;417:117075. PMID:32763508.
  9. Esposito EC, Jones KM, Galvagno SM Jr, Kaczorowski DJ, Mazzeffi MA, DiChiacchio L, Deatrick KB, Madathil RJ, Herrold JA, Rabinowitz RP, Scalea TM, Menaker J. Incidence of healthcare-associated infections in patients with fever during the first 48 hours after decannulation from veno-venous extracorporeal membrane oxygenation. Perfusion. August 2020:267659120948427. PMID:32820708.
  10. Radowsky JS, Mazzeffi MA, Deatrick KB, Galvagno SM, et al. Intoxication and overdose should not preclude veno-venous extracorporeal membrane oxygenation. Perfusion. October 2020:267659120963938. PMID:33043807.
  11. Galvagno SM Jr, Mazzeffi MA, Deatrick KB, Menaker J. The Age Barrier for VV ECMO-Where Should It Be? ASAIO J. 2021;67(1):e56. PMID:33074861.
  12. Spiegel R, Teeter W, Sullivan S, Tuchong K, Mohammed N, Sutherland M, Leibner E, Rola P, Galvagno Jr SM, Murthi SB. The use of venous Doppler to predict adverse kidney events in a general ICU cohort. Crit Care. 2020;24(1):615. PMID:33076961.
  13. Chow JH, Khanna AK, Kethireddy S, …Carpenter R,…Tanaka K, Galvagno SM, Scalea TM, Mazzeffi MA.. Aspirin Use Is Associated With Decreased Mechanical Ventilation, Intensive Care Unit Admission, and In-Hospital Mortality in Hospitalized Patients With Coronavirus Disease 2019. Anesth Analg. 2021;132(4):930-941. PMID:33093359.
  14. Richards JE, Medvecz AJ, O'Hara NN, Guillamondegui OD, O'Toole RV, Obremskey WT, Galvagno SM, Scalea TM. Musculoskeletal Trauma in Critically Injured Patients: Factors Leading to Delayed Operative Fixation and Multiple Organ Failure. Anesth Analg. 2020 Dec;131(6):1781-1788. doi: 10.1213/ANE.0000000000005252. PMID: 33186164.
  15. Shriki J, Galvagno SM Jr. Sedation for Rapid Sequence Induction and Intubation of Neurologically Injured Patients. Emerg Med Clin North Am. 2021;39(1):203-216. PMID:33218658.
  16. Tran QK, Famuyiwa O, Haase DJ, …Galvagno S. Care Intensity During Transport to the Critical Care Resuscitation Unit: Transport Clinician’s Role. Air Med J. 2020;39(6):473-478. PMID:33228897.
  17. Kelley KM. Galvagno SM, Wallis M, Mazzeffi MA, Deatrick K, Betzold R, Scalea T, Menaker J. Tracheostomy in Patients on Venovenous Extracorporeal Membrane Oxygenation: Is it Safe?. Am. Surg. 2020 Dec 19;3134820979595. doi: 10.1177/0003134820979595. Online ahead of print. PMID: 33342297.
  18. Quintana MT, Mazzeffi M, Galvagno SM, et al. A Retrospective Study of Infection in Patients Requiring Extracorporeal Membrane Oxygenation Support. Ann Thorac Surg. December 2020. PMID:33359722.
  19. Tabatabai A, Galvagno SM Jr, O’Connor JV, Scalea TM, Deatrick KB. Extracorporeal Life Support (ECLS): A Review and Focus on Considerations for COVID-19. Shock. 2021;55(6):742-751. PMID:33393754.
  20. Tabatabai A, Ghneim MH, Kaczorowski DJ, Shah A, Dave S, Haase DJ, Vesselinov R, Deatrick KB, Rabin J, Rabinowitz RP, Galvagno S Jr, O'Connor JV, Menaker J, Herr DL, Gammie JS, Scalea TM, Madathil RJ. Mortality Risk Assessment in Covid-19 Veno-Venous Extracorporeal Membrane Oxygenation. Ann Thorac Surg. 2021 Jan 21:S0003-4975(21)00104-1. doi: 10.1016/j.athoracsur.2020.12.050. Epub ahead of print. PMID: 33485917.
  21. Richards JE, Mazzeffi MA, Massey MS, Rock P, Galvagno Jr SM, Scalea TM. The Bitter and the Sweet: Relationship of Lactate, Glucose and Mortality After Severe Blunt Trauma. Anesth Analg; 2020 Dec 30. doi: 1213/ANE.0000000000005335. Online ahead of print. PMID: 33475264.
  22. Yang S, Mackenzie CF, Rock P, Lin C, Floccare D, Scalea T, Stumpf F, Winans C, Galvagno S, Miller C, Stein D, Hu PF. Comparison of massive and emergency transfusion prediction scoring systems after trauma with a new Bleeding Risk Index score applied in-flight. J Trauma Acute Care Surg. 2021;90(2):268-273. PMID:33502145.
  23. Lankford AS, Chow JH, Jackson AM, Wallis M. Galvagno Jr SM, Malinow AM, Turan OM, Menaker JA, Crimmins SD, Rector R, Kaczorowski D, Griffith B, Kon Z, Herr D, Mazzeffi MA. Clinical Outcomes of Pregnant and Postpartum Extracorporeal Membrane Oxygenation Patients. Anesth Analg. 2021;132(3):777-787. PMID:33591093.
  24. Nasa P, Azoulay E, Khanna AK, … Galvagno, Jr. SM,et al. Expert consensus statements for the management of COVID-19-related acute respiratory failure using a Delphi method. Crit Care. 2021;25(1):106. PMID:33726819.
  25. Shah A, Dave S, Galvagno S, et al. A Dedicated Veno-Venous Extracorporeal Membrane Oxygenation Unit during a Respiratory Pandemic: Lessons Learned from COVID-19 Part II: Clinical Management. Membranes. 2021;11(5). PMID:33919390.
  26. Richards JE, Fedeles BT, Chow JH, Morrison JJ. Renner C, Trinh AT, Schlee CS, Koerner K, Grissom TE, Bertzold, RD, Scalea TM, Kozar RA. Is Tranexamic Acid Associated With Mortality or Multiple Organ Failure Following Severe Injury? Shock. 2021;55(1):55-60. PMID:33337787.
  27. Grissom TE, Samet RE. The Anesthesiologist's Role in Teaching Airway Management to Nonanesthesiologists: Who, Where, and How. Adv Anesth. 2020 Dec;38:131-156. doi: 10.1016/j.aan.2020.08.002. Epub 2020 Oct 5. PMID: 34106831
  28. Huang N, Pérez P, Kato T, Mikami Y, et. al. Collaborators: Kleiner DE, Sampaio DM, . . . Chancer Z, Mazzeffi MA, Richards JE, et.al.SARS-CoV-2 infection of the oral cavity and saliva. Nat Med. 2021 May;27(5):892-903. doi: 10.1038/s41591-021-01296-8. Epub 2021 Mar 25. PMID: 33767405; PMCID: PMC8240394.
  29. Richards JE, Jackson BP. Whole blood for trauma patients: Outcomes at higher doses. Transfusion. 2021 Jun;61(6):1661-164. Doi: 10.1111/trf.16446. PMID: 34142730.
  30. Chow J, Richards J, Galvagno SM Jr, Coleman P, Lankford A, Hendrix C, Dunitz J, Ibrahim I, Ghneim M, Tanaka KA, Scalea TM, Mazzeffi MA, Hu P. The Algorithm Examining the Risk of Massive Transfusion (Alert) Score Accurately Predicts Massive Transfusion at the Scene of Injury and on Arrival to the Trauma Bay. 2021 Jun 24; Publish Ahead of Print. doi: 10.1097/SHK.0000000000001772.

Education

The Division is directly involved in educating medical students, nurse anesthetist students, residents and fellows. There are formal didactic sessions, lectures and rotations through a state of the art simulation center to develop clinical competencies. In addition, the department trains pre-hospital providers, emergency medicine residents and critical care fellows in airway management. The department offers a fellowship in Trauma Anesthesiology.

Faculty