Special section—acute care surgeryThe concept of acute care surgery: A vision for the not-so-distant future
Section snippets
Scenario 1
A 70-year-old motor-vehicle crash victim lies on the street. A passerby alerts the 911 operator who dispatches paramedics. They arrive within minutes, start resuscitation, maintain spinal control, load the ambulance, and communicate with the nearest trauma center. Beepers are activated around the hospital. The trauma team assembles and organizes itself, expecting the patient. The patient arrives, Advanced Trauma Life Support protocol is applied, and role-assigned health care providers work in
Scenario 2
A 70-year-old patient with multiple comorbidities experiences major left quadrant pain while his colonic diverticulum ruptures. He calls his primary care physician’s office; the answering machine picks up his call, and the message directs him to call back or go to a “hospital.” His relatives bring him to the emergency room (ER) in the early morning hours. The ER is busy, and he waits for an hour. Finally, an ER physician requests tests and surgical consult. The consult, a junior surgical
Scenario 3
It is July, around midnight, and a woman falls from a height of 30 feet. She is intubated on the field and transferred to the trauma center with multiple injuries. The surgical attending leads the trauma team and requests appropriate consults. Advice about the head injury is offered by the second-year neurosurgical resident, who happened to be this attending’s intern 1 month ago. The neurosurgical resident runs back and forth with the films to discuss the patient with his senior, who is
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