{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T16:56:05Z","timestamp":1755795365984,"version":"3.44.0"},"reference-count":25,"publisher":"BMJ","issue":"Suppl 3","license":[{"start":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T00:00:00Z","timestamp":1746835200000},"content-version":"unspecified","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Trauma Surg Acute Care Open"],"accepted":{"date-parts":[[2024,12,18]]},"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:p>Several interventions are generally thought to be \u2018life-saving\u2019 in the management and care of traumatically injured patients. The evidence supporting the utility of some interventions, however, is tenuous, if not outright contradictory to what occurs in the modern practice of trauma care. This was the topic of the Point Counterpoint 2024 Charles C. Wolferth lecture given by Nicholas Namias. This article will summarize his talk by highlighting multiple examples of interventions felt to be critical to the preservation of life in the trauma patient that, upon closer inspection, are not as well supported by evidence as one might think. These interventions include the expansion of trauma systems, sternotomy for hemopericardium, resuscitative endovascular balloon occlusion of the aorta (REBOA), prehospital intubation, and needle decompression of traumatic pneumothorax. By discussing the controversy surrounding these interventions, we hope to prompt the reader to question not only the nature and utility of their continued use but also what other closely held ideas and interventions deserve renewed scrutiny.<\/jats:p>","DOI":"10.1136\/tsaco-2024-001545","type":"journal-article","created":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T09:55:15Z","timestamp":1746870915000},"page":"e001545","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Are the life-saving interventions really life-saving?"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0746-8605","authenticated-orcid":false,"given":"Anthony J","family":"DeSantis","sequence":"first","affiliation":[{"name":"R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, Maryland, USA"},{"name":"Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9555-5698","authenticated-orcid":false,"given":"Melike","family":"Harfouche","sequence":"additional","affiliation":[{"name":"R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, Maryland, USA"},{"name":"Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7021-2250","authenticated-orcid":false,"given":"Nicholas","family":"Namias","sequence":"additional","affiliation":[{"name":"DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,5,10]]},"reference":[{"key":"2025081711071413000_10.Suppl_3.e001545.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2016.06.020"},{"key":"2025081711071413000_10.Suppl_3.e001545.2","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1097\/TA.0000000000001442","article-title":"The trauma ecosystem: The impact and economics of new trauma centers on a mature statewide trauma system","volume":"82","author":"Ciesla","year":"2017","journal-title":"J Trauma Acute Care Surg"},{"key":"2025081711071413000_10.Suppl_3.e001545.3","doi-asserted-by":"crossref","DOI":"10.1136\/tsaco-2024-001417","article-title":"Changes in payer mix of new and established trauma centers: the new trauma center money grab?","volume":"9","author":"Haddad","year":"2024","journal-title":"Trauma Surg Acute Care Open"},{"key":"2025081711071413000_10.Suppl_3.e001545.4","first-page":"51","article-title":"Statement on trauma center designation based upon system need","volume":"100","year":"2015","journal-title":"Bull Am Coll Surg"},{"key":"2025081711071413000_10.Suppl_3.e001545.5","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1097\/SLA.0000000000001838","article-title":"Impact of Volume Change Over Time on Trauma Mortality in the United States","volume":"266","author":"Brown","year":"2017","journal-title":"Ann Surg"},{"key":"2025081711071413000_10.Suppl_3.e001545.6","doi-asserted-by":"publisher","DOI":"10.1053\/j.semtcvs.2007.11.007"},{"key":"2025081711071413000_10.Suppl_3.e001545.7","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1949.01240030471006"},{"key":"2025081711071413000_10.Suppl_3.e001545.8","doi-asserted-by":"crossref","first-page":"1518","DOI":"10.1097\/TA.0b013e318254306e","article-title":"Does hemopericardium after chest trauma mandate sternotomy?","volume":"72","author":"Thorson","year":"2012","journal-title":"J Trauma Acute Care Surg"},{"key":"2025081711071413000_10.Suppl_3.e001545.9","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1097\/00005373-199506000-00004","article-title":"Role of echocardiography in the diagnosis of occult penetrating cardiac injury","volume":"38","author":"Nagy","year":"1995","journal-title":"J Trauma"},{"key":"2025081711071413000_10.Suppl_3.e001545.10","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1016\/j.injury.2004.08.005","article-title":"Haemopericardium in stable patients after penetrating injury: is subxiphoid pericardial window and drainage enough? 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