Thursday, May 19, 2005

Dr. Parker's Most Excellent Trauma Service

Bard Parker once again provides a superb description of trauma surgery today. It sounds like his night was a difficult one, at best. Seeing a fatal liver laceration with a likely retrohepatic vena caval injury and a duodenal laceration in the same night, from the same accident, will certainly keep one working into the wee hours of the morning. After reading his post to get a feel for what trauma surgery can be like, take a minute and review an earlier post about what problems face trauma care and what the future of trauma surgery look like.

As Dr. B. Parker has stated, trauma care is in large part nonoperative for the general surgeon involved. For that reason, I feel that the best type of person to care for trauma patients is the general surgeon who operates in the abdomen with frequency. This is classically the case, so that the occasional patient who needs urgent exploration, like the two described by Dr. Parker, receives care at the hands of the most capable surgeon available. Under the "emergent general surgeon" model that is currently being pushed by academic centers, I'm not sure that will be the case.