In this episode of the AAST Cutting Edge Podcast, host Dr. Caroline Park is joined by co-moderator Dr. Jeremy Levin and guests Dr. Alexandra Briggs and Dr. Miloš Buhavac to examine the rural trauma landscape, from the inconsistent definitions of "rural" to the resource gaps, transfer challenges, and workforce shortages that shape outcomes for patients far from major trauma centers. The episode opens with a clinical scenario: a critically injured patient at a Level III center awaiting transfer, raising immediate questions about transport time, available resources, and what Level I centers can realistically expect from their rural counterparts.

The panel discusses the uneven proliferation of trauma centers across the country, teletrauma as a tool for bridging expertise gaps and reducing non-therapeutic transfers, and the promise of geospatial data in planning smarter trauma systems for the future. Practical pathways for engagement, including the ACS Resource Variable Trauma Team Development Course (RTTDC) and regional advisory committees, are highlighted as ways trauma surgeons can better understand and support their referring facilities. The episode makes clear that sustaining rural trauma care requires not just placing surgeons in underserved areas, but building the systems, technology, and data infrastructure around them.

In this special collaboration episode of the Cutting Edge and Frontline Surgery podcasts, host Dr. Caroline Park is joined by co-hosts Dr. Joshua Dilday and Dr. Rachel Russo, along with national trauma leader Dr. Mary Margaret Knudson, to discuss surge capacity and workforce continuity in military-civilian partnerships. Dr. Knudson traces the history of mil-civ partnerships from World War II through the National Defense Authorization Acts of 2017 and 2018, and examines whether the current 25 Mission Zero-funded partnerships are truly preparing the trauma system for large-scale combat operations (LISCO).

The panel confronts a sobering reality: in a major conflict, military treatment facilities and embedded military personnel will all be deployed — leaving civilian trauma centers to receive combat casualties while already operating at capacity with reduced staffing. The episode explores what individual trauma centers and the national system must do now to prepare, including patient redistribution agreements, OR and ICU surge planning, and practicing combat casualty reception protocols well before they are needed.

The panel confronts a sobering reality: in a major conflict, military treatment facilities and embedded military personnel will all be deployed — leaving civilian trauma centers to receive combat casualties while already operating at capacity with reduced staffing. The episode explores what individual trauma centers and the national system must do now to prepare, including patient redistribution agreements, OR and ICU surge planning, and practicing combat casualty reception protocols well before they are needed.

In this episode of the AAST Cutting Edge Podcast, host Dr. Caroline Park and co-host Dr. Susan Kartiko are joined by Shira Rothberg, licensed clinical social worker and Trauma Survivors Network Coordinator at Inova Fairfax Hospital, to discuss Critical Incident Stress Management (CISM) and its role in supporting trauma and emergency department staff after high-impact cases. Drawing on her training through the International Critical Incident Stress Foundation (ICISF), Shira breaks down how structured debriefs help providers normalize acute stress responses, reconnect with their teams, and access further support when needed.

The conversation explores what CISM looks like in practice — from leadership recognition that a debrief is needed, to hybrid in-person and virtual formats, to the important distinction between something that is therapeutic and formal therapy. For trauma programs looking to implement CISM, the takeaway is clear: it starts with one or two trained facilitators and leadership buy-in — and once staff experience it, they keep coming back.