The specialty of trauma is at a crossroads. Choosing a career in trauma is associated with concerns related to lifestyle issues and maintenance of adequate operative experience. Trauma and critical care surgeons in the U.S. have reexamined their role based on these concerns and the realization that surgeon resources for the injured patient are in jeopardy. After much work over the past five years, a model of "Acute Care Surgery" has emerged and a training curriculum has been proposed. This article reviews the evolution of a new specialty and identifies some of the challenges and opportunities associated with the implementation of this model.

The inhibition of intraluminal pancreatic enzymes using enteroclysis with the serine protease inhibitor, NM, after hemorrhagic shock significantly improves the clinical outcome.

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