Dr. Pascal O. Udekwu

Without that information, it's hard to say what the findings really mean for patients, said Dr. Pascal "Osi" Udekwu, medical director of trauma and general surgery at WakeMed in Raleigh.Many transfusions are given either to surgical patients or those injured in accidents."This would be really important if they could show us an improved outcome," Udekwu, who is also an associate professor of surgery at UNC-Chapel Hill, said of the Duke studies.

Despite extensive media coverage of the threat of chemical and biological weapons, Americans are more likely to be injured in attacks with conventional explosives, claimed Pascal O. Udekwu, MBBS."You must be involved in the disaster planning process at your hospital so that you can best care for and save as many of these people as possible," stressed Dr. Udekwu, an Associate Professor of Surgery at the University of North Carolina in Raleigh.

Initially, the blast from a conventional explosive is most likely to damage the ears, gastrointestinal tract, and respiratory tract.Further trauma often occurs from burns and from propelled debris, such as dirt, stones, other natural material, shell casings, and body parts.

"In addition to the standard acute lung injury, you can also have significant air embolism," Dr. Udekwu warned.Bronchoscopy may reveal large air leaks; it can also be used to guide the surgical repair of such leaks.

Quick action may be necessary to provide an airway for those with severe respiratory distress, said Dr. Udekwu.He suggested conventional mechanical ventilation in these cases because "pulmonary injuries can be rapidly progressive" and lead to death.

Notably, blast victims may present with colonic perforation that must be found early to prevent sepsis."Perforated hollow viscous or other injuries will have a significant impact on morbidity and mortality in these patients after you have managed their initial airway and oxygenation issues," Dr. Udekwu noted.

Pascal O. Udekwu, MD, FCCP

Pascal O. Udekwu, MBBS, FCCP

Pascal Udekwu

Surgeon, WakeMed Associate professor of surgery, University of North Carolina at Chapel Hill Nominator comments: "The United States Army is desperately short on surgeons ... very few of the surgeons who do serve are specialized in trauma or have experience caring for patients with the kinds of injuries seen in a war zone."One of the highlights of the past year for Dr. Pascal Udekwu was caring for an 8-year-old boy who had swallowed a whistle five years prior.The whistle remained lodged in the child's left lung for a year before he was able to cough it up.The incident resulted in debilitating respiratory problems that remained until Udekwu performed a pneumonectomy, after which the boy was able to return to the activities of a normal young child.

Pascal O. Udekwu, MBBS, FCCP WakeMed Faculty Physicians

3300 Dundee Road • Northbrook, Illinois 60062-2348 • (847) 498-1400 • (800) 343-2227

Pascal Osi Udekwu, Director, Trauma Service
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Pascal Osi Udekwu, M.D.Director, Trauma Service and CARElina Medical Associates General Surgery, WakeMed, RaleighAssociate Professor, University of North Carolina at Chapel Hill