JACS Highlights

The following articles appear in the April 2024 issue of the Journal of the American College of Surgeons. A complimentary online subscription to JACS is a benefit of ACS membership. See more articles on the JACS website.

Impact of Prehospital Exsanguinating Airway-Breathing-Circulation Resuscitation Sequence on Patients with Severe Hemorrhage

Joseph Ritondale, BS, Mark Piehl, MD, Sydney Caputo, BS, and colleagues

Early prioritization of hemorrhage control and resuscitation with blood products after penetrating injury improves patient physiology and may prevent the need for immediate advance airway management. This is the first analysis to demonstrate a prehospital survival benefit from exsanguinating hemorrhage control airway-breathing-circulation in a subset of patients with severe injury and hemorrhagic shock. Read more.

Operating Room Supply Cost and Value of Care after Implementing a Sustainable Quality Intervention

Amanda C. Filiberto, MD, Tyler J. Loftus, MD, FACS, Cristina J. Crippen, RN, and colleagues

Surgical care accounts for nearly one-third of all US healthcare expenditures, with operating room (OR) costs constituting the second-most expensive part of surgical care after room and board. An automated, sustainable quality improvement intervention was implemented for 16 commonly performed procedures, including laparoscopic cholecystectomy, kidney transplant, and pediatric laparoscopic appendectomy. The authors found a decrease in OR supply cost and increased value of care, while patient outcomes were unchanged. Read more.

Home Is Not Always Where the Sleep Is: Effect of Home Call on Sleep, Burnout, and Surgeon Well-Being

Jamie J. Coleman, MD, FACS, Caitlin K. Robinson, MA, William von Hippel, PhD, and colleagues

Home call is commonly practiced across all surgical specialties. Over a 6-month study period, 171 acute care surgeons took 3,313 nights of home call, resulting in sleep disruption and increased feelings of burnout—even on nights during which the surgeon was never called. The authors write that the intensity and impact of home call should be taken into consideration when decisions are made both locally and nationally regarding call schedules and workforce needs. Read more.

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