The specialty of surgical critical care: A white paper from the American Association for the Surgery of Trauma Critical Care Committee

Michetti, Christopher P; J, Nahmias; Rangel, Erika L.; Rappold, Joseph F.; Gonzalez, Richard P.; Pathak, Abhijit; Kaups, Krista L.

doi:10.1097/ta.0000000000003629

Cited by 3 publications

(3 citation statements)

References 83 publications

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“…In the early 2000s, trauma surgery was thought to be going by the wayside. Trauma surgeons redefined themselves as specialists in all emergency surgeries and surgical critical care [ 31 ]. Different avenues for emergency physicians include prehospital care, home health, telemedicine, and further specialization in other niches within medicine through fellowship training in ultrasound, critical care, sports medicine, wilderness medicine, toxicology, and global health.…”

Section: Discussionmentioning

confidence: 99%

The 2022 and 2023 Emergency Medicine Residency Match: A Cautionary Tale

Lewis,

Williams,

Timpe

et al. 2023

Cureus

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Introduction The emergency medicine (EM) match has undergone significant shifts in 2022 and 2023. While variation in specialty fill rates is expected over time, EM programs noted a significant increase in open positions starting in 2022. Utilizing National Resident Matching Program (NRMP) data over a 10-year period, we identified significant deviations in the emergency medicine match. Methods Shewhart control charts were used to plot the match results over time. A 10-year sample was used to establish the baseline value. From this value, the upper and lower control limits were established. Residency program expansion, decreasing applicant numbers, and changing applicant types were evaluated to detect any non-random changes to the process. Results While the number of EM PGY-1 positions added over time was within the expected range, both the number of unmatched positions and the change in the number of total US MD applicants were outside of this range and are considered to be "out of control." Conclusion It is not yet clear which contributing causes may underlie this sudden change. Several potential etiologies exist, including mismatches in supply and demand for positions, changes in perceptions of the specialty, the effects of COVID-19, and changing workforce needs. Historically similar experiences affecting other specialties, including anesthesia and radiation oncology, are analyzed. Potential solutions for returning to the necessary and usual success of the emergency medicine specialty match are explored.

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Section: Discussionmentioning

confidence: 99%

The 2022 and 2023 Emergency Medicine Residency Match: A Cautionary Tale

Lewis,

Williams,

Timpe

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

“…Trauma surgeons treat severe trauma patients with hemodynamic instability. They are specialists at responding to respiratory collapse and sepsis in the ICU after primary resuscitation [14,15]. As the specialists of surgical critical care, they treat acute respiratory distress syndrome and pneumonia, and perform airway management including performing tracheostomies.…”

Section: Discussionmentioning

confidence: 99%

“…As the specialists of surgical critical care, they treat acute respiratory distress syndrome and pneumonia, and perform airway management including performing tracheostomies. They are well trained at inserting chest tubes as well as inserting various lines and tubes [14]. It is believed that they have sufficient ability to help infection-experts to treat the critically ill patients during a pandemic.…”

Section: Discussionmentioning

confidence: 99%

The Activities and Roles of Trauma Surgeons in the Treatment of COVID-19 Patients

Kim¹,

Youn²

2023

J Acute Care Surg

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Trauma surgeons' roles in a national hospital in Korea changed during the COVID-19 pandemic. In this study, we report on their roles over a 15-month period (March 2020 to May 2021) including the eight months where the hospital was a COVID-19-only hospital. Despite shortages in medical resources including medical personnel, and intensive care unit (ICU) beds, the trauma surgeons helped to control the public health problem by assuming various roles including working in another COVID-19 ICU in Dae-gu, treating trauma patients with COVID-19 or those who needed self-quarantine, being in charge of care for some COVID-19 patients in the ICU (for two months), and performing the role of a rapid response team member for COVID-19 ICU patients. In this report, we emphasize how trauma surgeons, along with intensivists, played an active role in treatment of COVID-19 patients, and helped prevent the collapse of the healthcare system within the hospital during the pandemic.

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Value in acute care surgery, part 4: The economic value of an acute care surgery service to a hospital system

Leichtle,

Murphy,

Nahmias

et al. 2024

J Trauma Acute Care Surg

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The Healthcare Economics Committee of the American Association for the Surgery of Trauma has published a series of three articles on the topic of value in acute care surgery (ACS). In this series, the key elements of value, cost and outcomes, and the impact of stakeholder perspective on what constitutes high-value care are discussed. The fourth article in this series continues the discussion by focusing on the unique economic value that an ACS service brings to a hospital system and its patients. Characterized by the immediate 24-hour availability of surgeons trained in trauma management, emergency general surgery, and surgical critical care, acute care surgeons extend the benefits of surgical rescue and critical care to all hospitalized patients. As such, an ACS service acts as a vital part of a hospital's infrastructure to successfully care for complex and seriously ill patients, in addition to enabling the establishment of other, high revenue-generating services such as vascular, transplant, and complex oncologic surgery programs. The trauma service acts as intake for patients that lead to downstream revenue creation by other disciplines such as orthopedic and neurological surgery, while trauma center designation itself results in dedicated state funding to ensure trauma readiness in many states in the United States. The traditional “value equation” in health care of outcomes achieved per dollar spent is ill-suited to capture many of these unique aspects and benefits of ACS. This article provides the background to understand the economic value of an ACS service and future directions toward improving overall value of care. LEVEL OF EVIDENCE Economic & Value-based Evaluations: Level IV.

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The specialty of surgical critical care: A white paper from the American Association for the Surgery of Trauma Critical Care Committee

Cited by 3 publications

References 83 publications

The 2022 and 2023 Emergency Medicine Residency Match: A Cautionary Tale

The 2022 and 2023 Emergency Medicine Residency Match: A Cautionary Tale

The Activities and Roles of Trauma Surgeons in the Treatment of COVID-19 Patients

Value in acute care surgery, part 4: The economic value of an acute care surgery service to a hospital system

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