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Introductory note: Trauma, Critical Care and Acute Care Surgery (TCCACS)/Medical Disaster Response (MDR) 2024
  1. Kenneth L Mattox
  1. Surgery, Baylor College of Medicine, Houston, Texas, USA
  1. Correspondence to Dr Kenneth L Mattox; redstart{at}aol.com

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This edition of TSACO provides a forum for selected, stimulating presentations from the Mattox Vegas Trauma, Critical Care and Acute Care Surgery (TCCACS) 2024 and Medical Disaster Response courses. The Trauma and Critical Care course was begun by Dr John Batdorf 57 years ago in Las Vegas, the same year that Caesars Palace opened, making us the longest running ‘show’ in Vegas! John Batdorf, Cuth Owens, and then Hank Cleveland were program directors over the years. During those early years, the hotel contract that now takes weeks of negotiating was a simple handshake between the chief executive officer of Caesars Palace and John, Cuth or Hank. Dr Batdorf told of covertly bringing conference ‘supplies’ into the hotel inside Resusci Anne when the meeting was in its infancy. They developed a course with a loyal following, and what began as a few good friends meeting annually to discuss current trends in surgery and trauma developed into an annual, well-respected and attended conference. In 1989, when registration had grown to around 300 annually, Mary Allen and Kenneth Mattox, at the request of Hank Cleveland, assumed the leadership roles for the course. Caesars, in the 1980s, put the conference up in lights on the Strip, welcoming conference attendees on the very neon sign that now heralds their headliner entertainers. Recognizing a medical conference in this way on the Strip had never before happened.

Medical Disaster Response made its debut in 2008, when Dr Asher Hirshberg, Mary, and I saw a need for a disaster course different from the many already in existence—a course focusing on the medical/clinical aspects, the most important determinant of survival in mass casualty events, and a course targeting the clinical personnel who are the first to receive victims. Each year, this course has been a unique platform for first-hand reporting and review of catastrophic events from medical and clinical standpoints, with emphasis on lessons learned. From discussions at this course came the new approach to the active shooter in a hospital, formation of regional agencies to integrate all emergency medical services and emergency preparedness organizations, an understanding of isolation needs and optimizing the use of space and personnel, among other key approaches to disaster response.

Both conferences use military experience, lessons learned, and military surgeons, active and reserve, to enhance the program content. Many of the 2024 faculty have spent time in Ukraine, Afghanistan, and other areas of conflict and bring unique and valuable knowledge that can only be imparted by those who have ‘lived it.’

In 2021, TCCACS was the first large ‘live and in-person’ conference to meet successfully and safely after the start of the COVID-19 pandemic. Nevada COVID-19 guidelines limited our audience to 500 attendees, a number we rapidly attained—all eagerly, seeking to learn and renew acquaintances with colleagues in person. 2021 introduced another first for us, producing the conference ‘On Demand,’ which we have continued through the present. Other than the ‘COVID-19 years,’ the TCCACS course has ‘sold out’ weeks to months before the start of the meeting, with attendance over 1000, the majority being practicing surgeons. For many attendees, this is their only professional meeting of the year. The program committees carefully select faculty to address critical, practical, and changing issues in surgery, trauma, surgical critical care, and acute care surgery. Our dedicated, expert, stimulating faculty are asked to address their subjects from scientific and clinically proven standpoints, avoiding dogma and unfounded guidelines. Changes in national and international surgery policies and standards have emerged from this conference. The growing faculty have, over the years, developed into a special relationship—we are a large, extended, bonded TCCACS ‘family, confident that when one calls on another, that call will be eagerly answered.’

Just a few of past conference highlights:

  • Captivating keynote luncheon—first-hand, riveting report of the successful rescue of the boys from the Thailand cave given by Master Sgt Derek Anderson

  • Gene Moore’s provocative keynote address on analysis of emerging changes in trauma and surgical training

  • Mattox’s analysis of the injuries, mechanisms, and treatments after the auto crash involving Princess Diana

  • Presentations and lively debates on emerging technology such as resuscitative endovascular balloon occlusion of the aorta, artificial intelligence, and rib plating, just to name a few—uses, pros, cons, complications, and developing data

  • Frequent reports of military experiences with burns, blasts, damage control, transportation and rehabilitation, one given directly from the war zone

  • Todd Maxson detailing his near-fatal motorcycle crash, immediate and prolonged treatment and recovery—trauma ‘from the other side of the table’

  • An annual session on Contemporary Issues in Surgery

  • A moving and illuminating presentation on the clinical and educational challenges of trauma surgery in areas of conflict by Dr David Nott

  • Urban and rural case management sessions that are always course highlights

Mattox Vegas TCCACS 2024 and Medical Disaster Response set the stage for over 80 presentations, two PLANNED spirited debates (and probably several more unscripted), as well as special keynote lectures. The 43 faculty were carefully selected, many of whom are repeatedly asked for by attendees. Others are recognized as rising young ‘stars’ in their areas of expertise and are joining us for the first time. One of our annual program goals is to bring back seasoned faculty, while seeking new, up-and-coming talent in TCCACS. An attendee described our course and faculty as, ‘an incredible journey in surgical knowledge, with ‘tour guides’ whose expertise and personalities make every excursion a uniquely exceptional experience.’ We ask much of our faculty, who waive their honoraria so we can contribute annually to the American College of Surgeons Committee on Trauma Resident Trauma Paper Competition, an idea that was begun by Dr Cleveland, and which we have been able to expand with annual scholarship awards to residents participating in the competition, as well as student scholarships. To date, the Vegas TCCACS has contributed nearly $1 million in donations and scholarships.

Our attendees represent practicing physicians from rural, urban, and academic settings. Each year, 48–50 states and 20–25 countries outside the USA are represented. Many return year after year, and their comments—‘Amazingly wonderful, fast-paced experience—like drinking water from a fire hose; it blew me away’ and ‘No other course like this in the world; can’t wait to return next year’ are the types of ‘reviews’ that fuel me, as the program director, Mary, the program coordinator, our program committee members, and our faculty to do our absolute best to ‘raise the bar’ each year.

This year, we are honored to have 12 presentations selected from the 2024 Mattox TCCACS and Medical Disaster Response to be published in this edition of TSACO. We appreciate this opportunity to extend some presented information to an even larger audience of surgeons and other clinicians eager to expand their knowledge and improve their practices. We are proud to be part of this new educational activity—an exciting, innovative way of providing the discerning reader an active evolution of surgical policy and philosophy.

I want to extend sincere appreciation to Doctors Matthew Martin, Tanya Egodage, and Purvi Patel, who, in addition to serving on the 2024 faculty, with all its demands (and they are significant), very successfully took on the added challenge of selecting, reviewing, and coordinating submission of the articles published in this TSACO edition, and to Dr Elliott Haut, editor of TSACO, for inviting TCCACS to participate in this endeavor.

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Footnotes

  • Contributors All authors contributed equally.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.