Management of Patients with Neurotrauma by Trauma Surgeons: Need of the Hour

Abstract

AbstractTrauma-related deaths in excess of 1 million occur annually in India, more than half of which are attributable to head injury. There are just 1,400 certified neurosurgeons in India, and only 300 new trainees are inducted every year. More than 80% of India’s specialist doctors live in urban India. There is evidence that patients travel hundreds of kilometers to seek a neurosurgeon; needless to say, golden hour of trauma is surely lost in this time. Scarcity of neurosurgeons is a problem in the developed world too. Government of India is building a national network of trauma centers for better trauma care. However, neurosurgeon availability at these centers remains a cause of concern. In dire need of neurotrauma management and scarcity of neurosurgeons, management of neurotrauma by trauma and general surgeons is the best available option. Such management policies have already been tested successfully in both developed (Germany, Sweden) and developing world (Nepal). There is evidence on patient safety and good outcome in neurotrauma management by trauma surgeons. Refresher training of 1 week every 2 years has been recommended to prevent skill attrition after 2-week neurotrauma training led by a neurosurgeon. Uninterrupted run of 3-year trauma surgery residency program at JPN Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India, incorporating in-house neurotrauma training is a testimony to need and utility of this approach. A “readily available neurosurgeon when needed” is a scarce resource in most parts of world. Therefore, trauma surgeon is best suited to deliver timely care in neurotrauma and tackle this “hidden epidemic.”