In this episode, James Gould and Rob Green sit down with Dr. Brian Lahiffe to discuss the Modified Brain Injury Guidelines (mBIG) — a risk stratification tool that is changing how emergency physicians disposition patients with mild traumatic brain injury and intracranial hemorrhage on CT.

Dr. Lahiffe walks us through the three-tiered mBIG framework, how it guides decisions around neurosurgical consultation, repeat imaging, and safe discharge, and the important caveats that apply — including anticoagulation and antiplatelet use. The conversation covers practical, real-world application of mBIG in the ED so you can approach your next head injury with clarity and confidence.

Go to www.trauma-ing.com for more FOAM stuff on trauma

In this episode, we sit down with Winny Li from Sunnybrook Health Sciences Centre to explore the Trauma Team Video Review (TTVR) program and its growing role in trauma care.

Winny Li is a clinician and quality improvement leader with expertise in trauma systems, simulation, and patient safety. She has been closely involved in the development and implementation of video review initiatives aimed at improving team performance and clinical outcomes.

We start by breaking down what trauma video review programs are and how they work in practice. The conversation highlights how these programs create powerful opportunities for learning, system improvement, and enhanced team communication.

We also dive into the real-world challenges of implementing TTVR, including concerns around privacy, medicolegal risk, cost, and cultural resistance. Importantly, we discuss practical solutions and strategies that have helped overcome these barriers, including stakeholder engagement, governance frameworks, and fostering a culture of psychological safety.

Whether you're involved in trauma care, education, or quality improvement, this episode offers valuable insights into how video review can transform team learning and patient care.

For more FOAM trauma stuff go to www.trauma-ing.com

In this episode, we sit down with Dr. Andrew W Kirkpatrick, Major (retired), trauma surgeon and critical care specialist based in Calgary, and Dr. Shane Smith, Lieutenant Colonel and vascular, trauma, and general surgeon at Western University.

Dr. Kirkpatrick was a key pioneer in the development of the RAPTOR (Resuscitation with Angiography, Percutaneous Techniques, and Operative Resuscitations) suite in Calgary, one of the earliest and most influential hybrid trauma resuscitation environments in North America. Together, we explore the evolution of RAPTOR/THOR (Trauma Hybrid Operating Room) concepts and how they are reshaping the management of severely injured patients.

We discuss the core benefits of these hybrid environments—most notably the ability to deliver definitive hemorrhage control faster by combining operative and endovascular capabilities in a single location, while minimizing delays and risks associated with patient transfers.

We also examine an important limitation: without thoughtful, forward-looking design, these suites risk becoming outdated. Rapid advances in standalone angiography and interventional technologies can outpace earlier-generation RAPTOR builds, highlighting the importance of flexibility and future-proofing when investing in these high-resource systems.

Check out www.trauma-ing.com for more FOAM trauma stuff