Providing Care for Critically Ill Surgical Patients

Abstract

Providing optimal care for critically ill and injured surgical patients will become more challenging with staff shortages for surgeons and intensivists. This white paper addresses the historical issues behind the present situation, the need for all intensivists to engage in dedicated critical care per the intensivist model, and the recognition that intensivists from all specialties can provide optimal care for the critically ill surgical patient, particularly with continuing involvement by the surgeon of record. The new acute care surgery training paradigm (including trauma, surgical critical care, and emergency general surgery) has been developed to increase interest in trauma and surgical critical care, but the number of interested trainees remains too few. Recommendations are made for broadening the multidisciplinary training and practice opportunities in surgical critical care for intensivists from all base specialties and for maintaining the intensivist model within acute care surgery practice. Support from academic and administrative leadership, as well as national organizations, will be needed.

Emergency Medicine Critical Care Certification: Challenges Ahead

“…The American Board of Surgery (ABS) pathway is managed through ABS and has separate criteria. 10 In essence all three pathways require different training paths. Additionally challenging is the application process, the utilization of the National Residency Matching Program (NRMP) and the Electronic Residency Application Service (ERAS) are different from institution and occasionally within the institution particularly since they may be program specific.…”

Bridging the Gap from T to K: Integrated Surgical Research Fellowship for the Next Generation of Surgical Scientists

“…Cutting-edge techniques and an aging US population have resulted in patients with advanced disease and more comorbidities, with exponential growth and intricacy in procedures. 11 Parallel to this evolution in the complexity of clinical care leading to increased specialization, advancements in biomedical knowledge have led to similar pressure for select expertise. The explosion of medical knowledge from the golden era of US Nobel Prize laureates in the 1960s created endless opportunities for biomedical research, but added layers of complexity to biologic processes that require multifaceted research teams.…”

A surgeon in the ICU: An equal “team-mate” or an “intruder”?

“…For surgeons interested in becoming intensivists, surgical societies should provide those who have completed critical care training and passed standardized examinations in critical care. The expectation is that they should gain the knowledge and skills necessary to manage critically ill patients [4,5]. All attempts must promote training in acute care surgery (the combination of trauma, surgical critical care, and emergency surgery) [5].…”