Acute Care SINS: Surgical Insights for the Non-surgeon

Abstract

Fortunately, trauma care is evolving rapidly. Unfortunately, trauma is still ubiquitous and still one of the leading causes of death, especially amongst the young. Trauma skills are now widely taught to surgeons and non-surgeons alike via courses such as the Advanced Trauma Life Support course and the Simulated Trauma and Resuscitation Team Training course. These practical courses emphasize that the initials “MD” really mean “make a decision.”Medical practitioners should understand trauma as a complex, multisystem, and multistage disease. For example, major trauma can cause enormous physiological stresses.This means that frail patients may not survive the acute insultand that others will be left battling the medical consequences (infections, myocardial damage, rhabdomyolysis, wound healing, etc.). Trauma also creates substantial psychological burdens for both patients and caregivers, whether through lost income, depression, divorce, or post-traumatic stress.Above all, there is a growing acceptance that in order to vanquish trauma, we need comprehensive and robust systems, not just doctors trained in isolation. Trauma is evolving into a fascinating science that blends knowledge, manual skills, ongoing practice, and system-wide commitment. Accordingly, trauma belongs in the bailiwick of both surgeons and non- surgeons. This chapter offers a basic primer. If you can establish the mechanism, apply anatomy, and find a modicum of courage, then patients may increasingly live to tell the tale.