Surgical Specialist
9 years of experience

Accepting new patients
Northwest Dallas
5323 Harry Hines Blvd
Dallas, TX 75390
214-648-0299
Locations and availability (4)

Education ?

Medical School Score
George Washington University (2001)
  • Currently 2 of 4 apples

Awards & Distinctions ?

Associations
American College of Surgeons
American Board of Surgery

Affiliations ?

Dr. Eastman is affiliated with 6 hospitals.

Hospital Affilations

Score

Rankings

  • UT Southwestern University Hospital - Zale Lipshy
    5151 Harry Hines Blvd, Dallas, TX 75235
    • Currently 4 of 4 crosses
    Top 25%
  • UT Southwestern University Hospital - St. Paul
    5909 Harry Hines Blvd, Dallas, TX 75235
    • Currently 4 of 4 crosses
    Top 25%
  • Parkland Health & Hospital System
    5201 Harry Hines Blvd, Dallas, TX 75235
    • Currently 1 of 4 crosses
  • UT Southwestern St Paul Hospital
  • Ut Southwestern Affiliated Hospitals
  • UT Southwestern Zale Lipshy Hospital
  • Publications & Research

    Dr. Eastman has contributed to 11 publications.
    Title Pre-burn Center Management of the Burned Airway: Do We Know Enough?
    Date January 2011
    Journal Journal of Burn Care & Research : Official Publication of the American Burn Association
    Excerpt

    Despite the traditional teaching of early and aggressive airway management in thermally injured patients, paramedics and medical providers outside of burn centers receive little formal training in this difficult skill set. However, the initial airway management of these patients is often performed by these preburn center providers (PBCPs). The purpose of this study was to evaluate the authors' experience with patients intubated by PBCPs and subsequently managed at the authors' center. A retrospective review of a level I burn center database was undertaken. All records of patients arriving intubated were reviewed. From January 1982 to June 2005, 11,143 patients were admitted to the regional burn center; 11.4% (n = 1,272) were intubated before arrival. In this group, mean age was 37.1 years, mean burn size was 35.3% TBSA, and mean length of hospital stay was 27.0 days. Approximately 26.3% were suspected of having an inhalation injury, and this was confirmed by either bronchoscopy or clinical course in 88.6% of this subgroup. Mortality in patients arriving intubated was 30.8%, and these were excluded from the rest of the analysis. In the surviving 879 intubated patients, reasons reported by PBCPs for intubation included "airway swelling" in 34.1%, "prophylaxis" in 27.9%, and "ventilation or oxygenation needs" in 13.2%. Of these patients, 16.3% arrived directly from the scene, with the remainder arriving from another hospital facility. Of all survivors who arrived intubated, 11.9% were extubated on the day of admission, 21.3% were extubated on the first postburn day (PBD), and 8.2% were extubated on the second PBD. No patients who were extubated on PBD1 or PBD2 had to be reintubated. A significant number of burn patients have their initial airway management by PBCPs. Of these, a significant number are extubated soon after arrival at the burn center without adverse sequelae. Rationale for their initial intubation varies, but education is warranted in the prehospital community to reduce unnecessary intubation of the burn patient.

    Title A Survey of Critical Care Training Amongst Surgical Residents: Will They Be Ready?
    Date September 2010
    Journal The Journal of Surgical Research
    Excerpt

    Residents' duty-hour limitations and the trends towards closed-staffing for surgical critical care (SCC) have reshaped educational paradigms. No study has yet addressed the impact of these changes on resident SCC training. In our study, we investigated residents' experiences and perceptions of SCC education and practice.

    Title Year in Review 2008: Critical Care--trauma.
    Date March 2010
    Journal Critical Care (london, England)
    Excerpt

    Eleven papers on trauma published in Critical Care during 2008 addressed traumatic brain injury (TBI), burns, diagnostic concerns and immunosuppression. In regard to TBI, preliminary results indicate the utility of either magnetic resonance imaging (MRI) or ultrasound in measuring optic nerve sheath diameter to identify elevated intracranial pressure (ICP) as well as the potential benefit of thiopental for refractory ICP. Another investigation demonstrated that early extubation of TBI patients whose Glasgow Coma Scale score was 8 or less did not result in additional incidence of nosocomial pneumonia. Another study indicated that strict glucose control resulted in worse outcomes during the first week after TBI, but improved outcomes after the second week. Another paper showed the prolonged neuroprotective advantages of progesterone administration in TBI patients. There was also guidance on improved classifications of renal complications in burn patients. Another study found that patients with inhalation injuries and increased interleukin-6 (IL-6) and IL-10 and decreased IL-7 had increased mortality rates. One literature review described the disadvantages of prolonged immobilization or additional use of MRI for ruling out cervical spine injuries in obtunded TBI patients already cleared by computerized tomography scans. Other investigators found that higher N-terminal pro B-type natriuretic peptide (NT-proBNP) levels may be useful markers for post-traumatic cardiac impairment. Finally, an experimental model showed that both splenic apoptosis and lymphocytopenia may occur shortly after severe hemorrhage, thus increasing the threat of immunosuppression in those with severe blood loss.

    Title The Lifesaving Potential of Specialized On-scene Medical Support for Urban Tactical Operations.
    Date January 2010
    Journal Prehospital Emergency Care : Official Journal of the National Association of Ems Physicians and the National Association of State Ems Directors
    Excerpt

    Since the 1980s, the specialized field of tactical medicine has evolved with growing support from numerous law-enforcement and medical organizations. On-scene backup from tactical emergency medical support (TEMS) providers has not only permitted more immediate advanced medical aid to injured officers, victims, bystanders, and suspects, but also allows for rapid after-incident medical screening or minor treatments that can obviate an unnecessary transport to an emergency department. The purpose of this report is to document one very explicit benefit of TEMS deployment, namely, a situation in which a police officer's life was saved by the routine on-scene presence of specialized TEMS physicians. In this specific case, a police officer was shot in the anterior neck during a law-enforcement operation and became moribund with massive hemorrhage and compromised airway. Two TEMS physicians, who had been integrated into the tactical law-enforcement team, were on scene, controlled the hemorrhage, and provided a surgical airway. By the time of arrival at the hospital, the patient had begun purposeful movements and, within 12 hours, was alert and oriented. Considering the rapid decline in the patient's condition, it was later deemed by quality assurance reviewers that the on-scene presence of these TEMS providers was lifesaving.

    Title Cta-based Screening Reduces Time to Diagnosis and Stroke Rate in Blunt Cervical Vascular Injury.
    Date September 2009
    Journal The Journal of Trauma
    Excerpt

    Advances in computed tomography capabilities have enabled trauma surgeons to screen for and diagnose the severity of blunt cervical vascular injury (BCVI) using computed tomographic angiography (CTA) alone. We hypothesized that the use of CTA-alone screening and diagnostic methods would reduce the time interval from admission to diagnosis and, hence, also reduce the stroke rates associated with these injuries.

    Title An Evaluation of Multidetector Computed Tomography in Detecting Pancreatic Injury: Results of a Multicenter Aast Study.
    Date March 2009
    Journal The Journal of Trauma
    Excerpt

    Efforts to determine the suitability of low-grade pancreatic injuries for nonoperative management have been hindered by the inaccuracy of older computed tomography (CT) technology for detecting pancreatic injury (PI). This retrospective, multicenter American Association for the Surgery of Trauma-sponsored trial examined the sensitivity of newer 16- and 64-multidetector CT (MDCT) for detecting PI, and sensitivity/specificity for the identification of pancreatic ductal injury (PDI).

    Title Conductive Electrical Devices: a Prospective, Population-based Study of the Medical Safety of Law Enforcement Use.
    Date July 2008
    Journal The Journal of Trauma
    Excerpt

    BACKGROUND: To examine police compliance with policies for the proper use of conductive electrical devices (CEDs) and, in turn, track any associated medical events following CED application. METHODS: Prospective, population-based, 15-month study of police activations of CEDs after their introduction into the police force of a large U.S. city (residential population, 1.25 million). Local policy for use was consistent with the recommendations of International Association of Chiefs of Police. Data collected included age, sex, predefined rationale for use, target distance, activation duration, total energy delivered, policy compliance, and medical findings or events within the first 12 hours. RESULTS: Among 426 consecutive CED activations (November 1, 2004 through January 31, 2006), the suspects' mean age (years +/- standard deviation) was 30 +/- 10 (range, 13-72) years and 90.4% were male. Suspects' mean distance from the officer was 5.0 +/- 4.5 feet (range, 0-21). Reasons for use included: evading or resisting arrest (33.3%, n = 142), public intoxication or disorderly conduct (15.8%, n = 76), interrupting a felony in progress (9.3%, n = 45), and interrupting an assault on an officer or public servant (6.0%, n = 29). Mean total duration of exposures was 8.6 +/- 5.9 seconds, and total energy delivered per suspect was 227 +/- 156 joules. Officers followed policy in all cases and, accordingly, all suspects rapidly received medical evaluation or simple first aid. No suspect required further treatment except one who was later found to have severe toxic hyperthermia and who died within 2 hours of activation despite rapid on-scene intervention. In 5.4% of deployments (n = 23), CED use was deemed to have clearly prevented the use of lethal force by police. CONCLUSION: Police were compliant with policy in all cases, and, in addition to avoiding the use of lethal force in a significant number of circumstances, the safety of CED use was demonstrated despite one death subsequently attributed to lethal toxic hyperthermia. Collaborative nationwide research using similar registries is strongly recommended to document compliance and ensure ongoing safety monitoring.

    Title Alternate Site Surge Capacity in Times of Public Health Disaster Maintains Trauma Center and Emergency Department Integrity: Hurricane Katrina.
    Date September 2007
    Journal The Journal of Trauma
    Excerpt

    BACKGROUND: Hospital surge capacity has been advocated to accommodate large increases in demand for healthcare; however, existing urban trauma centers and emergency departments (TC/EDs) face barriers to providing timely care even at baseline patient volumes. The purpose of this study is to describe how alternate-site medical surge capacity absorbed large patient volumes while minimizing impact on routine TC/ED operations immediately after Hurricane Katrina. METHODS: From September 1 to 16, 2005, an alternate site for medical care was established. Using an off-site space, the Dallas Convention Center Medical Unit (DCCMU) was established to meet the increased demand for care. Data were collected and compared with TC/ED patient volumes to assess impact on existing facilities. RESULTS: During the study period, 23,231 persons displaced by Hurricane Katrina were registered to receive evacuee services in the City of Dallas, Texas. From those displaced, 10,367 visits for emergent or urgent healthcare were seen at the DCCMU. The mean number of daily visits (mean +/- SD) to the DCCMU was 619 +/- 301 visits with a peak on day 3 (n = 1,125). No patients died, 3.2% (n = 257) were observed in the DCCMU, and only 2.9% (n = 236) required transport to a TC/ED. During the same period, the mean number of TC/ED visits at the region's primary provider of indigent care (Hospital 1) was 346 +/- 36 visits. Using historical data from Hospital 1 during the same period of time (341 +/- 41), there was no significant difference in the mean number of TC/ED visits from the previous year (p = 0.26). CONCLUSIONS: Alternate-site medical surge capacity provides for safe and effective delivery of care to a large influx of patients seeking urgent and emergent care. This protects the integrity of existing public hospital TC/ED infrastructure and ongoing operations.

    Title Computed Tomographic Angiography for the Diagnosis of Blunt Cervical Vascular Injury: is It Ready for Primetime?
    Date June 2006
    Journal The Journal of Trauma
    Excerpt

    INTRODUCTION: Although the reported sensitivity of computed tomographic angiography (CTA) for the diagnosis of blunt cervical vascular injury (BCVI) has been inadequate, we hypothesized that advances in computed tomographic technology have improved the diagnostic sensitivity of CTA at least to that of invasive catheter angiography (CA). METHODS: Data from all patients at risk for BCVI presenting to a Level I trauma center were collected prospectively. Each patient was evaluated with CTA and these findings were confirmed with standard catheter arteriograms (CA). RESULTS: Over 11 months, 162 patients were at risk for BCVI. In all, 146 patients received both CTA and CA. Forty-six BCVIs were identified among 43 patients. In 45 of 46 cases (98%), the results of CTA and CA were concordant. There was a single false-negative CTA in a patient with a grade I vertebral artery injury (VAI). The remaining 103 patients had normal CTAs confirmed by a normal CA. The overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CTA for the diagnosis of BCVI were 97.7%, 100%, 100%, 99.3%, and 99.3%, respectively. CONCLUSIONS: CTA, using a 16-channel detector, can be used to accurately screen at-risk patients for BCVI.

    Title Sentinel Lymph Node Biopsy Identifies Occult Nodal Metastases in Patients with Marjolin's Ulcer.
    Date September 2004
    Journal The Journal of Burn Care & Rehabilitation
    Excerpt

    Since Marjolin's description, the management of burn scar carcinoma has remained controversial. A multitude of options and recommendations exist for the management of both primary lesions and regional nodal metastasis. This work reviews six cases of Marjolin's ulcer staged using sentinel lymph node biopsy. All primary lesions were confirmed to be squamous cell carcinoma and occurred a median of 29.5 years after burn. No patient had clinically detectable lymphadenopathy. In all cases, preoperative lymphoscintigraphy successfully identified a single draining regional nodal basin. Subsequent intraoperative lymphatic mapping/sentinel lymph node (SLN) biopsy was successful in five of six cases (83%). A successful intraoperative lymphatic mapping/SLN biopsy was defined as the identification of blue (uptake of isosulfan blue dye) or "hot" (uptake of radiolabeled sulfur colloid as measured with a handheld gamma counter) node(s) and subsequent excision. Four of five SLN biopsies identified previously occult nodal metastasis. SLN biopsy represents a minimally invasive and accurate staging procedure for Marjolin's ulcer.

    Title Year in Review 2009: Critical Care - Cardiac Arrest, Trauma and Disasters.
    Date
    Journal Critical Care (london, England)
    Excerpt

    ABSTRACT : During 2009, Critical Care published nine papers on various aspects of resuscitation, prehospital medicine, trauma care and disaster response. One article demonstrated that children as young as 9 years of age can learn cardiopulmonary resuscitation (CPR) effectively, although, depending on their size, some may have difficulty performing it. Another paper showed that while there was a trend toward mild therapeutic hypothermia reducing S-100 levels, there was no statistically significant change. Another predictor study also showed a strong link between acute kidney injury and neurologic outcome while another article described a program in which kidneys were harvested from cardiac arrest patients and showed an 89% graft survival rate. One experimental investigation indicated that when a pump-less interventional lung assist device is present, leaving the device open (unclamped) while performing CPR has no harmful effects on mean arterial pressures and it may have positive effects on blood oxygenation and CO2 clearance. One other study, conducted in the prehospital environment, found that end-tidal CO2 could be useful in diagnosing pulmonary embolism. Three articles addressed disaster medicine, the first of which described a triage system for use during pandemic influenza that demonstrated high reliability in delineating patients with a good chance of survival from those likely to die. The other two studies, both drawn from the 2008 Sichuan earthquake experience, showed success in treating crush injured patients in an on-site tent ICU and, in the second case, how the epidemiology of earthquake injuries and related factors predicted mortality.


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