Edvardsen Busk (riddlelove01)

6 vs 5, p=0.02). Subset analysis showed a decrease in AR-MVC incidence in 18 to 29-year-olds (12.7% vs 7.5%; p=0.03), which was also demonstrated by data from a local law enforcement database. Availability of RSS was also correlated with a decreased proportion of nighttime AR-MVCs (14.7% vs 7.6%, p=0.03) and decreased number of DWIs (1198.0 ±78.5 vs 612.8 ±137.6, p= less then 0.01). Conclusions We found that the incidence of both total AR-MVCs and fatal AR-MVCs presenting to our trauma center decreased after the introduction of RSS. RSS may play a role in preventing AR-MVCs. Further research is needed to correlate AR-MVC incidence with granular proprietary RSS usage data and to account for any confounding factors. Future studies may identify ways to better utilize RSS availability as a targeted intervention for certain demographic groups to prevent AR-MVCs.Therapeutic/Care Management, Level 4.Background Thoracic surgery constitutes 2.5% of surgical procedures performed in theater, but the skills required are increasingly foreign to military surgeons. This study examines thoracic surgical workload in Iraq and Afghanistan to help define surgical training gaps. Methods Retrospective analysis of Department of Defense Trauma Registry (DoDTR) for all Role 2 (forward surgical) and Role 3 (theater) military facilities, from January 2002 to May 2016. The 95 thoracic surgical ICD-9-CM procedure codes were grouped into ten categories based on anatomy or endoscopy. Select groups were further stratified by type of definitive procedure. Procedure groupings were determined and adjudicated by surgeon subject matter experts. Data analysis used Stata Version 15 (College Station, Texas). Results Of the total procedures, 5,301 were classified as thoracic surgical procedures and were included in the present study. The majority of thoracic surgical procedures (4,645 (87.6%)) were recorded as being performed at R3 MTFs. The thoracic surgical procedures groups with the largest proportions were bronchoscopy (39.1%), thoracotomy (16.9%), diaphragm (15.6%), and lung (11.4%). The most common lung procedure subgroup, aside from NOS, was segmentectomy (28.8%). R3 MTFs recorded nearly 5 times the number of lung procedures compared to R2 MTFs; with R3 MTFs recording more than 8 times the number of lobectomies compared to R2 MTFs. Thoracic workload was variable over the 15 year study period. Conclusions Thoracic surgical skills are necessary in the deployed environment to manage combat-related injuries. Given the current trends in training and specialization, development and sustainment of thoracic surgical skills is challenging in the deployed US trauma system and likely for other nations, and humanitarian surgical care as well. Current training and practice paradigms pose both training and sustainment challenges for surgeons who deploy to a combat zone. Level of evidence Level III, epidemiologic study.Mass casualty incidents (MCIs) put substantial stress on loco-regional resources, and trauma centers are critical to responding to these events. Our previous evaluation of Canadian centers helped to identify several weaknesses in disaster responsiveness. In this analysis, we determined the current state of MCI readiness across Canada and how this has changed over time. A multinational cross-sectional survey-based study on MCI preparedness was performed, including 24 Canadian trauma centers. Surveys were completed anonymously online by representatives of each facility. Responses from Canadian centers were examined and compared to previous findings to assess temporal changes in institutional capacity. Fifteen (63%) trauma centers responded, 100% of which had a disaster committee. Sixty percent had a single all-hazards emergency plan, and 71% performed a practice drill in the last two years. Sixty-two percent had communications systems designed to function during an MCI. Ninety-two percent had a triage system in place, and 54% of centers could monitor surge cap