Trauma surgery is a
surgicalSurgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
specialtyA specialty in medicine is a branch of medical science. After completing medical school, physicians or surgeons usually further their medical education in a specific specialty of medicine by completing a multiple year residency to become a medical specialist.-History of medical specialization:To...
involved in the invasive treatment of physical injuries, typically in an emergency setting. Trauma surgeons generally complete
residencyResidency is a stage of graduate medical training. A resident physician or resident is a person who has received a medical degree , Podiatric degree , Dental Degree and who practices...
training in general surgery and often fellowship training in trauma or surgical
critical careCritical care may refer to:* Critical care medicine or intensive-care medicine, a branch of medicine concerned with life support for critically ill patients* "Critical Care" , an episode of the TV series...
. The trauma surgeon is responsible for the initial resuscitation and stabilization of the patient, as well as ongoing evaluation and management. The attending trauma surgeon also leads the trauma team, which typically includes nurses and support staff as well as resident physicians in teaching hospitals.
Training
In the US, the majority of trauma surgeons practice in larger centers and complete a 1-2 year fellowship in surgical critical care. This allows them to sit for the
American Board of SurgeryThe American Board of Surgery is an independent, non-profit organization based in Philadelphia, Pennsylvania founded for the purpose of certifying surgeons who have met a defined standard of education, training and knowledge...
(ABS) certifying examination in Surgical Critical Care. This is generally considered the board certification for "trauma surgery".
In Europe training programs usually take place under supervision of the national surgical boards, who also certify for subspecialism as trauma surgery. There is also an official European trauma surgical exam.
Training for trauma surgeons is sometimes difficult to obtain. In the United Kingdom, the
Royal College of Surgeons of EnglandThe Royal College of Surgeons of England is an independent professional body and registered charity committed to promoting and advancing the highest standards of surgical care for patients, regulating surgery, including dentistry, in England and Wales...
is responsible for training consultants via the
Definitive Surgical Trauma SkillsThe Definitive Surgical Trauma Skills course is a joint development between The Royal College of Surgeons of England, The Royal Centre for Defence Medicine and The Uniformed Services University of the Health Sciences in Washington DC, USA....
course (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 as well as civilian surgeons.
Responsibilities
The broad scope of their surgical critical care training enables the trauma surgeon to address most injuries to the neck, chest, abdomen, and extremities. In large parts of Europe trauma surgeons treat most of the musculoskeletal trauma. Whereas injuries to the central nervous system are generally treated by neurosurgeons. In the US and Britain skeletal injuries are treated by trauma orthopedic 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 radiologistsInterventional radiology is a specialty of radiology, in which image-guided procedures are used to diagnose and treat a multitude of diseases across all body systems...
are involved in treating trauma patients.
Trauma surgeons must be familiar with a large variety of general surgical, thoracic, and
vascularVascular in zoology and medicine means "related to blood vessels", which are part of the circulatory system. An organ or tissue that is vascularized is heavily endowed with blood vessels and thus richly supplied with blood....
procedures and must be able to make complex decisions, often with little time and incomplete information. Proficiency in all aspects of
intensive care medicineIntensive-care medicine or critical-care medicine is a branch of medicine concerned with the diagnosis and management of life threatening conditions requiring sophisticated organ support and invasive monitoring.- Overview :...
/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 that of general surgeons.
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 to the operating room,
intensive care unitthumb|220px|ICU roomAn intensive-care unit , critical-care unit , intensive-therapy unit/intensive-treatment unit is a specialized department in a hospital that provides intensive-care medicine...
, and hospital floor. In most settings, patients are evaluated according to a set of predetermined protocols (
triageTriage or ) is the process of determining the priority of patients' treatments based on the severity of their condition. This rations patient treatment efficiently when resources are insufficient for all to be treated immediately. The term comes from the French verb trier, meaning to separate,...
) 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.
General Surgery
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 musculoskeletal. For this reason, part of US trauma surgeons devote at least some of their practice to
general surgeryGeneral surgery, despite its name, is a surgical specialty that focuses on abdominal organs, e.g., intestines including esophagus, stomach, small bowel, colon, liver, pancreas, gallbladder and bile ducts, and often the thyroid gland . They also deal with diseases involving the skin, breast, soft...
. In most American university hospitals and medical centers, a significant portion of the emergency general surgery calls are taken by trauma surgeons. The field combining trauma surgery and emergency general surgery is often called acute care surgery.
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