Subacute Care Surgery (was trauma activation and stratificati on)

[Moore677 at aol.com]

Agreed..............thanks for the eloquent clarification

Dell..........................................................................
..


Forrest O. Moore, MD
Division of Trauma & Surgical Critical Care
East Texas Medical Center
1020 E. Idel
Tyler, TX 75701
Cell (903) 279-2123



In a message dated 10/4/2006 12:58:45 PM Eastern Standard Time, 
brombwi1 at memorialhealth.com writes:
This is clearly a case of two cultures speaking PAST each other. There seems 
to be two major misunderstandings. Firstly is the design of the trauma 
"system." From the little I know about trauma care in the UK (please correct me if I 
err)  it is not really a "system" and indeed surgeons are not at the helm. 
However in the US the trauma system was sort of initiated (very broadly) by the 
American College of Surgeons. In order to be a trauma center you have to have 
surgeons immediately available (within 15 minutes). In order to be a Level I 
trauma center you have to have either 1) an attending surgeon IN HOUSE 24/7/365 
or 2) a chief surgical resident in house 24/7/365 with attending backup 
available within 15 minutes. 

The second misapprehension seems to be the qualifications of the trauma 
surgeon. In the vast majority of Level I trauma centers the responsible surgeons 
have completed a critical care fellowship (1-2 years) after their 5-year general 
surgical residency. This prepares them to deal with AMI + trauma, stroke + 
trauma, and etc and etc (the final common pathway for many diseases seems to be 
a car crash on the way to the hospital or "found down" with a contusion on the 
head * ergo trauma). While there are indeed a number of non-trauma/CC trained 
surgeons taking trauma call at a number of fine institutions, most of the 
patients in the ICU are cared for by Trauma Surgeon Intensivists. 

I hope this serves to clear up some of the confusion. I also note that 
calling people idiots or their comments "BS" rarely adds to the utility of the 
conversation.

Bill Bromberg

William J. Bromberg
Savannah Surgical Group
912 350-7412