N M Rich

Uniformed Services University of the Health Sciences, 베서스다, Maryland, United States

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Publications (221)569.68 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Vascular injuries comprised a small percentage of total injuries requiring medevac in the Iraq and Afghanistan conflicts; however, their impact cannot be overstated. This case highlights an individual who sustained a grenade blast injury leading to hemorrhage, and forearm compartment syndrome. He was initially treated with irrigation and debridement, forearm fasciotomy, and delayed primary closure. The patient developed persistent ulnar neuropathy and hypothenar atrophy despite a normal initial vascular examination. During reconstructive surgery, he was discovered to have a proximal ulnar artery pseudoaneurysm. Upper extremity pseudoaneurysms are a rare sequelae following vascular injury, but have significant consequences for the patient and are identifiable by imaging. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.
    06/2015; 180(6):e725-7. DOI:10.7205/MILMED-D-14-00400
  • David R Welling, Norman M Rich, Eric Elster
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    ABSTRACT: This paper describes a model humanitarian mission to Guyana; it illustrates the value of excellent ongoing care in collaboration with local physicians and surgeons, cooperation with local government and medical officials, and frequent periodic follow-up missions (always to the same hospital, working with the same staff). This effort has largely avoided the so-called "Seven Sins of Humanitarian Medicine".
    World Journal of Surgery 03/2015; DOI:10.1007/s00268-015-3049-x · 2.35 Impact Factor
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    ABSTRACT: Background Ratios of women graduating from the only US military medical school and entering surgical internships were reviewed and compared to national trends. Methods Data was obtained from the USUHS graduation announcements from 2002-2012. Results There were 1771 graduates from 2002-2012 with 508 female (29%) and 1263 male (71%). Female graduates increased over time (21-39%; p=0.014). Female general surgery interns increased from 3.9% to 39% (p=0.025). Female overall surgical subspecialty interns increased from 20% in 2002 up to 36% in 2012 (p=0.046). Women were represented well in obstetrics (57%), urology (44%) and otolaryngology (31%), but not in neurosurgery, orthopedics and ophthalmology (0-20%). Conclusion The gender disparity between military and civilian medical students occurs before entry. Once in medical school, females are just as likely to enter general surgery or surgical subspecialty as their male counterparts. Increased ratio of females in the class is unlikely to lead to a shortfall except in specific subspecialties.
    The American Journal of Surgery 10/2014; 208(4). DOI:10.1016/j.amjsurg.2014.05.009 · 2.41 Impact Factor
  • Military medicine 07/2014; 179(7):704-707. DOI:10.7205/MILMED-D-14-00034 · 0.77 Impact Factor
  • David R. Welling, Norman M. Rich
    04/2014; 2(2):226–229. DOI:10.1016/j.jvsv.2012.07.009
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    ABSTRACT: The purpose of this report is to record some of the recent accomplishments of the Surgery Interest Group (SIG) at the Uniformed Services University of the Health Sciences, and to provide a framework for others to follow, with the goal of encouraging students to become interested in the exciting field of surgery. We will outline some of the events that our SIG planned and carried out in order to provide a quality experience to its members.
    Military medicine 12/2012; 177(12):1548-50. DOI:10.7205/MILMED-D-12-00278 · 0.77 Impact Factor
  • David R Welling, Norman M Rich
    Journal of the American College of Surgeons 10/2012; DOI:10.1016/j.jamcollsurg.2012.08.029 · 4.45 Impact Factor
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    Journal of vascular surgery: official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter 09/2012; 56(6). DOI:10.1016/j.jvs.2012.06.103 · 2.98 Impact Factor
  • James S T Yao, Roger T Gregory, Norman M Rich
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    ABSTRACT: The purpose of the SVS is not just to hold an annual meeting, but also to pursue social, financial, and political responsibilities. In addition, the Society leads in research, training, education, and practice (ie, patient care). The current leadership of the SVS is dedicated to preserving the history of the Society. The History Project Work Group will execute the orders of the Society to develop a series of digital videography recorded interviews with leaders in vascular surgery to be made available to our membership. The information collected will form the basis for a book on the history of the SVS.
    Journal of vascular surgery: official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter 07/2012; 56(3):e52-7. DOI:10.1016/j.jvs.2012.04.065 · 2.98 Impact Factor
  • Journal of vascular surgery: official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter 01/2012; 55(1):286-90. DOI:10.1016/j.jvs.2011.10.085 · 2.98 Impact Factor
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    David Welling, Norman Rich
    World Journal of Surgery 01/2012; 36(1):5-7. DOI:10.1007/s00268-011-1325-y · 2.35 Impact Factor
  • The Journal of trauma 05/2011; 70(5):1291-3. DOI:10.1097/TA.0b013e3182178994 · 2.96 Impact Factor
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    Norman M Rich
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    ABSTRACT: This article provides a brief historical review of treatment of vascular trauma. Although methods for ligation came into use in the second century, this knowledge was lost during the Dark Ages and did not come back until the Renaissance. Many advances in vascular surgery occurred during the Balkan Wars, World War I, and World War II, although without antibiotics and blood banking, the philosophy of life over limb still ruled. Documenting and repairing both arteries and veins became more common during the Korean and Vietnam conflicts. Increased documentation has revealed that the current conflicts have resulted in more arterial injuries than in previous wars, likely because of improved body armor, improvised explosive device attacks, tourniquet use, and improved medical evacuation time. This brief review emphasizes the great value of mentorship and the legacy of the management of arterial and venous injuries to be passed on.
    Perspectives in Vascular Surgery 04/2011; 23(1):7-12. DOI:10.1177/1531003511403496
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    ABSTRACT: To develop an arterial injury model for testing hemostatic devices at well-defined high and low bleeding rates. A side-hole arterial injury was created in the carotid artery of sheep. Shed blood was collected in a jugular venous reservoir and bleeding rate at the site of arterial injury was controlled by regulating outflow resistance from the venous reservoir. Two models were studied: uncontrolled exsanguinating hemorrhage and bleeding at controlled rates with blood return to maintain hemodynamic stability. Transcutaneous Duplex ultrasound was used to characterize ultrasound signatures at various bleeding rates. A 2.5 mm arterial side-hole resulted in exsanguinating hemorrhage with an initial bleeding rate of 400 ml/min which, without resuscitation, decreased to below 100 ml/min in 5 minutes. After 17 minutes, bleeding from the injury site stopped and the animal had lost 60% of total blood volume. Reinfusion of shed blood maintained normal hemodynamics and both high and low bleeding rates could be maintained without hemorrhagic shock. Bleeding rate at the arterial injury site was held at 395±78 ml/min for 8 minutes, 110±11 ml/min for 15 minutes, and 12±1 ml/min for 12 minutes. Doppler flow signatures at the site of injury were characterized by high peak and end-diastolic flow velocities at the bleeding site which varied with the rate of hemorrhage. We have developed a hemodynamically stable model of acute arterial injury which can be used to evaluate diagnostic and treatment methods focused on control of the arterial injury site.
    Polish Journal of Surgery 01/2011; 83(1):1-9. DOI:10.2478/v10035-011-0001-0
  • Annales de Chirurgie Vasculaire 12/2010; 24(8). DOI:10.1016/j.acvfr.2011.05.001
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    ABSTRACT: Endovascular techniques are often applied, but they have occasionally been reported in the treatment of popliteal vascular entrapment (PVE). A case of bilateral PVE is presented with an acute occlusion of the right popliteal artery. This was twice unsuccessfully treated with arterial recanalization and stenting at another Institution. The patient required an arterial reconstruction with his reversed saphenous vein, in addition to resection of the medial gastrocnemius muscle laterally inserted on his right limb. The left limb was treated with a simple myotomy. Recanalization and stenting is not recommended for PVE treatment.
    Annals of Vascular Surgery 11/2010; 24(8):1135.e1-3. DOI:10.1016/j.avsg.2010.03.010 · 1.03 Impact Factor
  • Journal of vascular surgery: official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter 11/2010; 52(5):1405-9. DOI:10.1016/j.jvs.2010.04.060 · 2.98 Impact Factor
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    Journal of vascular surgery: official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter 09/2010; 52(3):790-3. DOI:10.1016/j.jvs.2010.02.286 · 2.98 Impact Factor
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    Journal of vascular surgery: official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter 08/2010; 52(2):508-11. DOI:10.1016/j.jvs.2010.01.093 · 2.98 Impact Factor
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    ABSTRACT: The need for humanitarian assistance throughout the world is almost unlimited. Surgeons who go on humanitarian missions are definitely engaged in a noble cause. However, not infrequently, despite the best of intentions, errors are made in attempting to help others. The following are seven areas of concern: 1. Leaving a mess behind. 2. Failing to match technology to local needs and abilities. 3. Failing of non-governmental organizations (NGO's) to cooperate and help each other, and and accept help from military organizations. 4. Failing to have a follow-up plan. 5. Allowing politics, training, or other distracting goals to trump service, while representing the mission as "service". 6. Going where we are not wanted, or needed and/or being poor guests. 7. Doing the right thing for the wrong reason. The goal of this report is to discuss these potential problems, with ideas presented about how we might do humanitarian missions more effectively.
    World Journal of Surgery 03/2010; 34(3):466-70. DOI:10.1007/s00268-009-0373-z · 2.35 Impact Factor

Publication Stats

3k Citations
569.68 Total Impact Points

Institutions

  • 1983–2015
    • Uniformed Services University of the Health Sciences
      • • Department of Surgery
      • • F. Edward Hebert School of Medicine
      • • Department of Medicine
      베서스다, Maryland, United States
  • 2009
    • University of California, San Francisco
      • Department of Surgery
      San Francisco, CA, United States
  • 1972–2003
    • Walter Reed National Military Medical Center
      • • Division of Vascular Surgery
      • • Department of Surgery
      Washington, Washington, D.C., United States
  • 1997
    • Helsinki University Central Hospital
      • Department of Surgery
      Helsinki, Uusimaa, Finland
  • 1992
    • St. Petersburg College
      St. Petersburg, Florida, United States
  • 1980–1990
    • Walter Reed Army Institute of Research
      Silver Spring, Maryland, United States