Medicine and Health Sciences Commons^™

Indications For Resection Of Metastatic Liver Lesions, Vivian Mcalister

Vivian C. McAlister

No abstract provided.

Pancreatic Cancer: Define Unresectable, Vivian Mcalister

Vivian C. McAlister

No abstract provided.

Causes Of Death In Canadian Forces Members Deployed To Afghanistan And Implications On Tactical Combat Casualty Care Provision., D Pannell, R Brisebois, M Talbot, V Trottier, J Clement, N Garraway, Vivian C. Mcalister, H Tien

Vivian C. McAlister

BACKGROUND: As part of its contribution to the Global War on Terror and North Atlantic Treaty Organization's International Security Assistance Force, the Canadian Forces deployed to Kandahar, Afghanistan, in 2006. We have studied the causes of deaths sustained by the Canadian Forces during the first 28 months of this mission. The purpose of this study was to identify potential areas for improving battlefield trauma care.

METHODS: We analyzed autopsy reports of Canadian soldiers killed in Afghanistan between January 2006 and April 2008. Demographic characteristics, injury data, location of death within the chain of evacuation, and cause of death were determined. …

Principles Of Combat Surgical Care In A Staged Evacuation System, Vivian C. Mcalister, Rob Stiegelmar, Brian Church, Ray Kao

Vivian C. McAlister

Background: The NATO hospital classification of hospitals describes an orderly transfer of patients with severe injuries through a series of increasingly sophisticated hospitals as they are brought from the point of injury to their home hospital. Forward hospital surgery is restricted to damage control and resuscitation while definitive surgery is performed at home by the destination surgical team. In reality many patients enter the hospital chain higher up and some receive definitive surgery as they proceed through the chain of evacuation. The purpose of this paper is to determine if clear doctrine exists to guide the performance of surgery on …

Utilization Profile Of The Trauma Intensive Care Unit At The Role 3 Multinational Medical Init At Kandahar Airfield Between May 1 And Oct. 15, 2009., Sha K, Pirie S, Compton L, Vivian C. Mcalister, Brian Church, Ray Kao

Vivian C. McAlister

Background: In the war against the Taliban, Canada was the lead North Atlantic Treaty Organization (NATO) nation to provide medical and surgical care to NATO soldiers, Afghanistan National Army soldiers, Afghanistan Nation Police, civilians working in and outside Kandahar Airfield and Afghanistan civilians at the Role 3 Multinational Medical Unit (R3MMU) from February 2006 to October 2009. Methods: We obtained data from the Joint Theatre Trauma Registry between May 1 and Oct. 15, 2009; 188 patients were admitted to the R3MMU intensive care unit (ICU). We analyzed the ICU data according to types and causes of trauma, mechanical ventilation prevalence, …

The Role 3 Multinational Medical Unit At Kandahar Airfield 2005-2010., R Brisebois, P Hennecke, R Kao, Vivian C. Mcalister, J Po, R Stiegelmar, H Tien

Vivian C. McAlister

In late 2005, Canadian Forces Health Services (CFHS) was tasked with the command of the NATO Role 3 Multinational Medical Unit (R3MMU) on Kandahar Airfield in southern Afghanistan. Preparations drew on past experience and planning. Eight complete hospital contingents were trained and deployed in rotation. Near-reality simulation training was undertaken with the combat brigade, including complete deployment of the field hospital in the exercise area. Standard operating procedures (SOP) were developed and applied by each rotation so successfully that they were adopted by the new command in late 2009. The Canadian period at R3MMU had the highest survival rate ever …

The Role Of Surgery In Building Resilience To Blast Attacks, Vivian C. Mcalister

Vivian C. McAlister

Blast attacks are the commonest form of terrorist attack on civilians. Blast often causes injury from industrial accidents. Blast injury is the most common cause of injury and death in modern combat. A recent review of Canadian fatal casualties in Afghanistan found 81% to have been caused by blast, almost four times the number killed by gun shot wounds. Improvised explosive devices (IED) caused 78% of the blasts with another 20% being due to rocket propelled grenades (RPG).1 The purpose of this review is to outline the mechanisms of injury, to define the surgical response and to understand the implications …

Drills And Exercises: The Way To Disaster Preparedness, Vivian C. Mcalister

Vivian C. McAlister

Catastrophes, natural or man-made, are very rare events in the life of hospitals in the developed world. None of the hospitals that coped with well known recent events such as Hurricane Katrina or the Madrid bombings had actually experienced or prepared for such an occurrence. A mass casualty incident (MCI), sometimes called “MASCAL,” is a situation in which a hospital receiving multiple casualties does not have the resources to deal with the patients simultaneously. Bottlenecks may occur at any point from the trauma bays to the point of discharge. There are 2 phases in which hospitals fail to cope. In …

“Noted Surgeon, Fine Citizen”: The Life Of Archibald E Malloch, Md 1844–1919 By Charles G. Roland, Chloe Mcalister, Vivian C. Mcalister

Vivian C. McAlister

No abstract provided.

Composite Tissue Allotransplantation To Treat Veterans With Complex Amputation Injuries, Vivian C. Mcalister, Ray Kao, Brian Church, Markus Besemann, Rob Stiegelmar

Vivian C. McAlister

Amputee rehabilitation may be limited by complexity of injury (e.g. bilateral arm amputation), associated injury (e.g. colostomy) or by the level of amputation (e.g. high above knee). Our objective is to assess the potential for composite tissue allotransplantation (CTA) to overcome these barriers. Medical literature was searched and programs were surveyed regarding the current status of CTA. Results CTA remains an experimental reconstructive option that involves a large collaborative (physiatry, orthopaedic, plastic and transplant surgeons). Limb transplantation has evolved out of limb reimplantation surgery and organ transplantation. Approximately 10 programs world wide, with almost a decade of experience, report 90% …

Do Older Patients Utilize Excess Health Care Resources After Liver Transplantation?, Neil Shankar, Mamoon Albashir, Paul Marotta, William Wall, Vivian C. Mcalister, Natasha Chandok

Vivian C. McAlister

INTRODUCTION: Liver transplantation is a highly effective treatment for end-stage liver disease. However, there is debate over the practice of liver transplantation in older recipients (age ≥ 60 years) given the relative shortage of donor grafts, worse post-transplantation survival, and concern that that older patients may utilize excess resources postoperatively, thus threatening the economic feasibility of the procedure.

AIM: To determine if patients ≥ 60 years of age utilize more health resources following liver transplantation compared with younger patients.

MATERIAL AND METHODS: Consecutive adult patients who underwent primary liver transplantation (n = 208) at a single center were studied over …

Mass Casualty Training Exercise At The Canadian Surgery Forum

Vivian C. McAlister

On September 18, 2011 second year Schulich School of Medicine & Dentistry students helped run the first mass casualty training exercise, directed by Dr. Vivian McAlister, Division of General Surgery, at the Canadian Surgery Forum held this year at the London Convention Centre.