Behind the Night, the Surgery Podcast, relevant and engaging content designed to help you dominate the day.

Alright, thanks for listening to Behind the Night. This is Patrick Georgia off and BTK

Surgery Education Fellow Nina Clark and we've got a special episode for you today. This is our first ever BTK

row down, a spicy debate, an epic battle, a war of words and ideas between giants in the field of trauma surgery.

All of whom were compelled, or at least I guess in some cases triggered, by a recently published paper in the Journal of Acute Care

in a Trauma Surgery that explored time to vascular access in trauma patients, and they used a video review to do so.

And the authors concluded that an I quote, intraocious access should be considered a first-line therapy in hypotensive trauma patients end quote.

And with that line we're drawn and Twitter Alliance is formed. So let's introduce our throwdown contestants.

In the pro IO corner, we have the papers first author, Dr. Ryan Dumas, who's an Assistant Professor of Surgery at UT Southwestern in Dallas,

and Dr. Michael Vella, who's an Assistant Professor of Surgery, and the Trauma Medical Director at the University of Rochester, Kessler Trauma Center.

I'm going to jump in here if I can, Mike Vellan. So I need to disclose that I am a paid speaker for Telaflex Corporation.

What does Telaflex make? Well, they make East Gallo, but I can tell you that I talk about the Quick Flight Line of Project products and the other relationships that started after this.

And in the anti IO corner, unfortunately, one of our contestants had to drop out of last minute that was Dr. Dennis Kim, who's Professor of Surgery at the University of British Columbia,

where he's also the Medical Director of Trauma Services on Vancouver Island. And amazingly enough, those kind-hearted Canadians apparently are propagating some violence today.

And Dr. Kim had to run to the operating room for some emerging cases. So fortunately, we have Dr. Belal Joseph, who will most definitely hold it down for Dr. Kim in his absence.

Dr. Joseph is Professor of Surgery and Chief of General Surgery and Vice Chair of Research in the Department of Surgery at the University of Arizona.

So with that, ladies and gentlemen, let's get ready to rumble.

Yeah, if I had a nickel for every time I heard somebody had an emerging case and bowed out of a debate at the last minute, I would be a real woman.

But first, let's give everybody some background on this paper. We're talking about a paper that was titled Moving the Needle on Time to Resuscitation, an East prospective multi-center study of vascular access in hypotensive injured patients using trauma video review.

So this was a multi-center prospective observational study that was supported by East using data obtained from trauma video review, which we'll get into in a little bit.

The researchers wanted to look at how we obtain access to start resuscitating hypotensive trauma patients. Specifically, they hypothesized that IO access would be faster and more likely successful than peripheral IVs or central lines.

The study included data from 19 centers that were all part of this multi-center study, and patients were included if they were over the age of 16, hypotensive on arrival, and if they had a new attempt at getting access in the trauma bay.

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