Vancouver General Hospital trauma research

Our multidisciplinary team is made up of specialists from critical care medicine, nursing, injury prevention, epidemiology, and health systems design. Our primary areas of research include improving care for patients with multiple or complex social needs, surgical care delivery in rural and remote areas and low-income countries, trauma system design and injury prevention, prevention of venous thromboembolism and the development and evaluation of risk stratification tools for major hemorrhage.

As a Level 1 trauma center, Vancouver General Hospital (VGH) is at the epicentre of high-end clinical trauma care in British Columbia (BC). As such, we strive to provide excellent care for our patients, to the limits that are humanly possible. To do so, our mandate is to remain at the forefront of the latest advances in trauma care and to study their outcomes in our patient population. 

Our group is currently studying the use of Extra-Corporeal Life Support (ECLS) for severely injured trauma patients. We were one of the first centers to implement Resuscitative Balloon Occlusion of the Aorta (REBOA) and therefore are studying the process of implementation of this technology in our center and across Canada. 

We boast a concurrent and detailed trauma registry, which allows us to study clinical issues including chest wall trauma, pancreatic trauma, blunt cerebrovascular injury and venous thromboembolism. We successfully contribute to multicenter clinical trials, most recently a randomized trial on rib fracture fixation. Educating our trainees in trauma care is a key aspect of delivering excellent clinical care. We are one of the participating centers in the TraumaRECON trial, which is measuring the exposure of general surgery residents to trauma during their training.

Experiences with trauma systems development, quality improvement and research are highly translatable to the newly emerging field of Emergency General Surgery (EGS). Our group has already published widely on the clinical and educational impact of the implementation of structured EGS services. As a member of the newly formed Canadian Collaborative of Urgent Care Surgery (CANUCS), we have been a pivotal force in leading the way on several multicenter research studies (available at: www.canucs.ca). 

Our ongoing research includes measuring the impact of the COVID pandemic on surgical care and exploring the impact of failure to rescue in quality-improvement processes. VGH recently became one of the 15 international centers enrolling patients in the COOL trial, looking at open versus closed abdomen post laparotomy in patients with severe sepsis.

Twenty percent of our patients are referred from other facilities, some of them rural and remote. Our group is committed to strengthening trauma care in those sites, by building a strong trauma system rooted in evidence-based practices, training and mentorship. Dr. David Evans leads the Specialist Trauma Advisory Network (STAN), tasked with creating clinical practice guidelines applicable to all hospitals in BC. Telementoring is a key aspect of strengthening capacity, and we have built and studied this relationship with a rural hospital in Revelstoke, BC. More broadly, our group is acutely aware of the gap in surgical care delivery in low-income countries and actively searching for solutions. We are currently doing a study on evaluating a surgical task-sharing program in South Sudan.

The VGH Trauma Program participates in providing innovative education opportunities and a top-tier research platform for studying acutely ill and injured patients.