Samual R Todd

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BACKGROUND Acidosis, hypothermia, and coagulopathy were identified more than 20 years ago as a deadly triad for patients presenting with exsanguinating hemorrhage. This led to fundamental changes in initial management of severely injured patients. Despite major advances, hemorrhage remains a leading cause of early death in trauma patients. Recent studies(More)
BACKGROUND We initiated a multidisciplinary clinical pathway targeting patients greater than 45 years of age with more than 4 rib fractures. The purpose of the current study was to evaluate the effect of this pathway on infectious morbidity and mortality. METHODS This was a prospective cohort study. Data evaluated included patient demographics, injury(More)
BACKGROUND Acute lower extremity compartment syndrome (ALECS) is a devastating complication that often presents silently in critically injured patients; therefore, we developed a protocol to screen high-risk patients. METHODS This prospective observational study included all Shock Trauma intensive care unit patients who met specific high-risk criteria(More)
BACKGROUND Sepsis is the leading cause of mortality in noncoronary intensive care units. Recent evidence based guidelines outline strategies for the management of sepsis and studies have shown that early implementation of these guidelines improves survival. We developed an extensive logic-based sepsis management protocol; however, we found that early(More)
BACKGROUND Studies on stress hyperglycemia in trauma patients have largely ignored diabetes, a potential confounder. The purpose of this study was to assess the relationship between diabetes and outcome in trauma patients. METHODS Data were obtained from the National Trauma Data Bank (version 4.0). The primary outcome measures were mortality and(More)
Nutrition supplementation is paramount to the care of severely injured patients. Despite its widespread use in trauma patients, many areas of clinical practice remain controversial. The purpose of this paper is to critically review the literature studying the use of enteral vs parenteral nutrition (PN) and to provide the rationale for early enteral(More)
Previously, we developed a protocol for shock resuscitation of severe trauma patients to reverse shock and regain hemodynamic stability during the first 24 intensive care unit (ICU) hours. Key hemodynamic measurements of cardiac output and preload were obtained using a pulmonary artery catheter (PAC). As an alternative, we developed a protocol that used(More)
BACKGROUND Necrotizing soft-tissue infections (NSTIs) are rare and highly lethal. METHODS A retrospective chart review of patients with NSTIs treated at 6 academic hospitals in Texas between January 1, 2004 and December 31, 2007. Patient demographics, presentation, microbiology, treatment, and outcome were recorded. Analysis of variance, chi-square test,(More)
BACKGROUND The debate continues over type and quantity of fluid to administer for resuscitation after traumatic injury. This study aimed to examine effects of resuscitation with lactated Ringer's (LR) and Hextend (HEX) on the inflammatory response after uncontrolled hemorrhagic shock (UHS). METHODS There were 38 swine randomized. Control swine were(More)
BACKGROUND The purpose of this study was to assess how surgical intensive care unit (SICU) patients and their families would perceive robotic telepresence. We hypothesized that they would view such technology positively. METHODS This research was an Institutional Review Board-approved prospective observational study. Our robotic telepresence program(More)