Trauma surgery

Trauma surgeons are physicians (MBBS, MBChB, MB, MD) or (DO) who have completed residency training in general surgery and fellowship training in trauma or surgical critical care. The trauma surgeon is responsible for the initial resuscitation and stabilization of the patient, as well as ongoing evaluation. The attending trauma surgeon also leads the trauma team, which typically includes nurses, resident physicians, and support staff.

The majority of trauma surgeons practicing in larger centers complete a 1-2 year fellowship in surgical critical care. This allows them to sit for the American Board of Surgery (ABS) certifying examination in Surgical Critical Care. If this is passed, the examinee is then recognized as having a qualification in Surgical Critical Care. There is no separate board or examination for "trauma surgery".

The broad scope of their surgical critical care training enables the trauma surgeon to address most injuries to the neck, chest, abdomen, and extremities (other than fractures). Injuries to the central nervous system are generally treated by neurosurgeons. Musculoskeletal injuries are treated by orthopaedic surgeons. Facial injuries are often treated by maxillofacial surgeons. There is significant variation across hospitals in the degree to which other specialists, such as cardiothoracic surgeons, plastic surgeons, vascular surgeons, and interventional radiologists are involved in treating trauma patients. Most patients presenting to trauma centers have multiple injuries involving different organ systems, and so the care of such patients often requires a significant number of diagnostic studies and operative procedures. The trauma surgeon is responsible for prioritizing such procedures and for designing the overall treatment plan. This process starts as soon as the patient arrives in the emergency department and continues on to the operating room,intensive care unit, and hospital floor. In most settings, patients are evaluated according to a set of predetermined protocols designed to detect and treat life-threatening conditions as soon as possible. After such conditions have been addressed (or ruled out), non-life-threatening injuries are addressed.

Over the last few decades, a large number of advances in trauma and critical care have led to an increasing frequency of non-operative care for injuries to the neck, chest, and abdomen. Most injuries requiring operative treatment are orthopedic or neurosurgical in nature. For this reason, most trauma surgeons devote at least some of their practice to general surgery. In most U.S. university hospital|medical centers, a significant portion of emergency general surgery call is taken by trauma surgeons. This increases the operative case load for trauma surgeons and allows other general surgical specialists (such as gastrointestinal surgeons, surgical oncologists, and vascular surgeons) to focus on their own respective areas.

Trauma surgeons must be familiar with a large variety of general surgical, thoracic, and vascular procedures and must be able to make complex decisions, often with little time and incomplete information. Proficiency in all aspects of intensive care medicine|critical care is required. Hours are irregular and there is a considerable amount of night, weekend, and holiday work. Salaries for trauma surgeons are comparable to those for general surgeons.

Training for Trauma Surgeons

Training for trauma surgeons is sometimes difficult to obtain. In the United Kingdom, the Royal College of Surgeons of England is responsible for training consultants via the Definitive Surgical Trauma Skills course, or the 'DSTS'. It remains the only course of its kind in the United Kingdom. Originally designed to teach the military, the course now trains both military and civilian surgeons.

Further reading

* [http://www.aast.org American Association for the Surgery of Trauma] , a website dedicated to the advancement of knowledge in treating and preventing traumatic injuries.
* [http://www.aofoundation.org/wps/portal/surgeryskully AO Surgery Reference]
* [http://www.trauma.org trauma.org] a website dedicated to trauma
* [http://www.rcseng.ac.uk/education/courses/surgical_trauma.html Definitive Surgical Trauma Skills]

* [http://www.east.org Eastern Association for the Surgery of Trauma] , major association of trauma surgeons in the US.
* [http://www.traumafoundation.org/public/ National foundation for Trauma Care]