DOCSLIB.ORG

Trauma, Surgical Critical Care and Acute Care Surgery Services

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Trauma, Surgical Critical Care and Acute Care Surgery Services Trauma, Surgical Critical Care and Acute Care Surgery Services Region’s most experienced nationally verified Level I trauma center The University of Kansas Hospital is the largest regional resource for trauma and acute care surgery. Our multidisciplinary team provides expert care from the time of injury or illness through the patient’s post-hospitalization rehabilitation. The University of Kansas Hospital focuses this specialty practice on the 3 facets of acute care surgery: emergency surgery, trauma surgery and surgical critical care. Our trauma and acute care specialists are in the hospital 24 hours a day, 7 days a week, providing expert surgical care. We specialize in high-acuity surgical and trauma patients with multisystem injuries and complex surgical conditions. • Because we see a large volume of patients, we excel at providing care to surgical and trauma patients. • Our comprehensive approach to care involves a multidisciplinary team that specifically specializes in caring for acute surgical and trauma patients. • As part of an academic medical center, we are active in surgical research, forging new techniques that lead to improved care and recovery. • We are continually focused on quality improvement for optimal outcomes. PB200320120 Specialized care team Level I trauma care Trauma, critical and acute care Concussion management Trauma and acute care surgery patients The Level I Trauma Center at The University of Our surgeons are board-certified in general Timely and effective concussion treatment receive comprehensive treatment from a Kansas Hospital serves the highest volume of surgery and surgical critical care. They provide is important for recovery. Our concussion multidisciplinary team of professionals, each trauma patients in the region. We treat twice the most advanced and comprehensive care to management team is led by a multidisciplinary specializing in the care of surgical patients. the number of trauma patients as the next critically injured patients. group of physicians in neurology, trauma, Our physician and nursing leaders are largest trauma center. As a regional referral sports medicine, physical medicine, pediatrics nationally recognized experts in their fields. center, we receive transfers from more than Surgical critical care specialists provide and rehabilitation. These experts are 100 different hospitals in 26 states. high-quality care to some of the most critically innovators in the field of concussion The team includes: ill patients in our hospital. Conditions that we research and treatment. • Board-certified surgeons with additional Our highly trained trauma surgeons are on manage: qualifications in surgical critical care site 24 hours a day, 7 days a week. Our board- • Multisystem organ failure ENT reconstruction • Sepsis and life-threatening infections • Nurses certified emergency medicine physicians Ours is the only hospital in the region with a • Respiratory failure • Therapists specialize in trauma care and work together team of microvascular surgeons experienced • Post-operative care • Nutritionists with our trauma surgeons to stabilize patients. in head and neck reconstruction. Surgeons • Shock • Case managers use these specialized reconstructive • Other critical illnesses • Neuropsychologists In an instant, we can mobilize a team of trauma techniques to treat traumatic injuries. • Other specialists trained surgeons, emergency medicine physicians, Acute care surgery conditions that we treat: to care for the specific needs of a neurosurgeons, orthopedists, plastic surgeons, Urologic trauma surgical patient radiologists and other specialists. • Cholecystitis • Intestinal obstruction/perforation We have the only fellowship-trained specialist in urologic trauma and reconstruction in Kansas Continuous quality improvement In addition, we are the injury treatment • Appendicitis • Colitis City and the region. We offer the latest and We participate in risk-adjusted benchmarking and medical care provider for the Kansas • Abdominal wall hernias best treatment options in the field of urologic of patient outcomes on a national level for City Chiefs, Kansas City Royals and • Soft tissue infections trauma and genital reconstructive surgery. both surgical and trauma care. This enables Kansas Speedway. • Other acute surgical conditions us to critically analyze and refine our care so Trauma education we achieve some of the best surgical patient Our trauma center serves other providers in outcomes in the nation. Orthopedic traumatologists These board-certified surgical specialists the region with education courses year-round. are fellowship-trained in orthopedic trauma. Courses include ATLS, FCCS, ASSET, TNCC, They handle complex and compound injuries, B-Con and more. including pelvic fractures, dislocations and soft tissue injuries. Accreditation and awards • ACS-Verified Level I Trauma Center Neurosurgical expertise since 2000 • Emergency Nurses Association’s Our experienced neurosurgeons are nationally Lantern Award recognized experts in the evaluation, diagnosis • ABA- Verified burn center since 1999 and treatment of injuries to the brain, spinal cord • ABA-Verified pediatric burn center and nervous system. We provide aggressive and since 2011 advanced treatment for traumatic brain injury and offer comprehensive care for spinal For more information trauma patients and patients with complex, Patients: 913-588-1227 | 844-323-1227 multisystem injuries. Physicians: 913-588-5862 | 877-588-5862 kansashealthsystem.com/trauma To transfer a patient 877-738-7286.
Load more

Recommended publications
  • A BRI H IEF HISTO Howard R. C ORY of TH the Champion, K HE
    A BRIEF HISTORY OF THE FOUNDING OF THE EASTERN ASSOCIATION FOR THE SURGERY OF TRAUMA (EAST) Howard R. Champion, Kimball I. Maull, Lenworth M. Jacobs, Burton H. Harris A BRIEF HISTORY OF THE FOUNDING OF THE EASTERN ASSOCIATION FOR THE SURGERY OF TRAUMA (EAST) Howard R. Champion, Kimball I. Maull, Lenworth M. Jacobs, Burton H. Harris The Eastern Association for the Surgery of Trauma (EAST) was founded by a group of surgeons each of whom had somewhat established themselves in the field of trauma and surgical critical care by the early 1980s and were in the process of developing these disciplines and mentoring young surgeons. EAST has widely exceeded the original aspirations of that group of then-young surgeons. To understand why EAST was created and why it succeeded, it is necessary to glance back to the mid 1980s. The notion of EAST occurred in 1985 within a context of a growing demand for organized trauma care but no appropriate opportunities for young aspiring trauma surgeons to exchange knowledge, discuss advances in patient care, or develop their careers in this field within the discipline of surgery. No vehicle adequately nurtured young surgeons into the field of trauma. Today, EAST is an established and respected surgical organization reaching its 25-year mark with membership (Figure 1) of 1363 now exceeding that of the premier global trauma organization, the American Association for the Surgery of Trauma (AAST) (1227 members). Then The world of the young trauma surgeon in the early to mid 1980s was a very different place than it is more than 25 years later.
    [Show full text]
  • History of Cardiac Trauma Surgery
    History of cardiac trauma surgery A J Nicol, MB ChB, FCS (SA), PhD; P H Navsaria, MB ChB, FCS (SA), MMed (Surg); D Kahn, MB ChB, FCS (SA), ChM Department of Surgery, Groote Schuur Hospital, Cape Town, South Africa Corresponding author: A Nicol ([email protected]) The ancient Egyptians, although realising the diaphragm, of the small intestine, of the coronary artery and that blood in the the anatomical importance of the heart, stomach and of the liver is deadly.’[8,9] Aristotle pericardial sac could compress the heart and were largely responsible for the aura of (384 - 322 BC) wrote that ‘The heart again restrict its movement.[17] mysticism and superstition that enveloped is the only one of the viscera, and indeed the heart for centuries. The Egyptian Book the only part of the body, that is unable to The nihilism surrounding cardiac injuries of the Dead (c. 1567 BC) describes how, on tolerate any serious affection. This is but what continued and in 1804 John Bell published entry to the underworld, the jackal-headed might reasonably be expected. For, if the his Discourses of Nature and Care of Wounds, Anubis weighed the heart of the deceased primary or dominant part be diseased, there declaring that ‘there is so little to be done … against a statue of the goddess of truth and is nothing from which the other parts which and the signs and consequences are so clear, justice.[1,2] If the heart weighed the same, the depend upon it can derive sucour’.[10,11] Celsus that it is a waste of time to speak longer of dead person was admitted ‘to the company (1st century AD) recognised the clinical wounds of the heart’.[5,18] of Osiris and the blessed; if not, if his heart features of shock associated with a cardiac was heavy and laden with sin, it was cast to injury when he wrote in De Medicina that, There is dispute over who should be named the devouring beast Ammit’.[3] ‘When the heart is wounded much blood as the first modern cardiac surgeon.
    [Show full text]
  • Trauma Surgery (PDF)
    Edward Via College of Osteopathic Medicine 4th Year Clinical Rotation: Surgical Critical Care MED 8305: Surgical Selective Clinical Rotation COURSE SYLLABUS Chair Contact Information Michael Breiner, MD Phone: 540-231-0600 Chair of Surgery - VC Email: [email protected] Tom Lindsay, DO Phone: 864-327-9842 Associate Chair of Surgery - CC Email: [email protected] Paul Brisson, MD Phone: 334-442-4023 Chair of Surgery - AC Email: [email protected] I. Rotation Description Students will gain hands-on experience in the diagnosis and management of critically injured and acutely ill general surgery, neurosurgery, and trauma patients. Students function as an integral part of the surgical critical care team. The team is responsible for all aspects of critical care including bedside procedures, ventilatory and post-surgical management. Students will present patients on daily ward rounds and take call. II. Rotation Goals The goal of this rotation is to acquire the knowledge and skills necessary to manage patients with problems unique to the surgical intensive care setting. Additionally, students will appreciate the differences in management strategies between the surgical and medical intensive care units. Bedside teaching and procedure training will occur as part of the daily workrounds. a. Basic knowledge that is needed for the resuscitation, diagnosis and treatment of Surgical Critical Care, including General Surgery, Trauma, and Neurosurgery patients b. Instruction in the basic clinical skills needed to treat Surgical Critical Care, including General Surgery, Trauma, and Neurosurgery patients c. An understanding of the continuum of care involved in the treatment of trauma patients from the resuscitation bay through discharge from the ICU.
    [Show full text]
  • World Journal of Critical Care Medicine
    World Journal of W J C C M Critical Care Medicine Submit a Manuscript: http://www.wjgnet.com/esps/ World J Crit Care Med 2015 August 4; 4(3): 240-243 Help Desk: http://www.wjgnet.com/esps/helpdesk.aspx ISSN 2220-3141 (online) DOI: 10.5492/wjccm.v4.i3.240 © 2015 Baishideng Publishing Group Inc. All rights reserved. MINIREVIEWS Intensive care organisation: Should there be a separate intensive care unit for critically injured patients? Tim K Timmers, Michiel HJ Verhofstad, Luke PH Leenen Tim K Timmers, Luke PH Leenen, Department of Surgery, care units with an “open format” setting. However, there University Medical Center Utrecht, 3508 GA Utrecht, The are still questions whether surgical patients benefit from Netherlands a general mixed ICU. Trauma is a significant cause of morbidity and mortality throughout the world. Major or Michiel HJ Verhofstad, Department of Surgery, Erasmus severe trauma requiring immediate surgical intervention Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands and/or intensive care treatment. The role and type of the ICU has received very little attention in the literature Author contributions: Timmers TK designed the research; Timmers TK and Leenen LPH performed the research; Timmers when analyzing outcomes from critical injuries. Severely TK, Verhofstad MHJ and Leenen LPH wrote the paper. injured patients require the years of experience in complex trauma care that only a surgery/trauma ICU Conflict-of-interest statement: The authors declared that they can provide. Should a trauma center have the capability have no competing interests. of a separate specialized ICU for trauma patients (“closed format”) next to its standard general mixed ICU? Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external Key words: Intensive trauma care; Trauma intensive reviewers.
    [Show full text]
  • Surgical Critical Care Skills
    Parkland SICU and Parkland MICU Skills and Assessments The program is designed to give the Fellow in-depth instruction in the many aspects of surgical critical care. The multi-disciplinary nature of the Fellowship with rotations in Burn Surgery, Neurosurgery and Pediatric Surgery allows application of knowledge and skills across multiple disciplines. This is further ensured through the delivery of critical care to a large volume of patients. I. Cardiopulmonary Systems/Monitoring and Medical Instrumentation Knowledge Skills Assessment 1. Understand pathophysiology Insert pulmonary artery, central Faculty observation associated with different causes of venous and arterial lines and obtain during rounds, skills hemodynamic instability. Examples hemodynamic data; interpret data and courses (PA Catheter, include types of shock, cardiac arrest. initiate therapy. Instruct junior ICU Ultrasound) and residents in insertion of invasive resuscitation as monitors and interpretation of data. documented on Resuscitate patients from shock and evaluations. cardiac arrest. 2. Know and apply treatments for Recognize and treat ischemia and Observation during arrhythmias, congestive heart failure, arrhythmia on ECG. Utilize correct rounds, MCCKAP as acute ischemia and pulmonary edema. class of anti-arrhythmic, vasodilators noted on evaluation. and diuretics as they pertain to cardiac disease. Be able to interpret and instruct current ACLS guidelines. 3. Understand factors associated with Ability to assess preoperative risk Observation during assessment of preoperative surgical risk. based on history, physical exam, rounds, MCCKAP as Examples include evaluation of the high laboratory and radiographic data. noted on evaluation. risk cardiac patient undergoing non- Correctly interpret data and optimize cardiac surgery. the high-risk cardiopulmonary patient for surgery. 4.Understand pathophysiology Proficiency and ability to instruct in Direct observation; case associated with respiratory failure.
    [Show full text]
  • The Imaging of Maxillofacial Trauma and Its Pertinence to Surgical Intervention
    The Imaging of Maxillofacial Trauma and its Pertinence to Surgical Intervention Nisha Mehta, MDa, Parag Butala, MDb, Mark P. Bernstein, MDa,* KEYWORDS Maxillofacial trauma Surgery Imaging Maxillofacial skeletal injuries account for a large positioning is difficult and potentially dangerous proportion of emergency department visits and for multitrauma patients, in particular patients often result in surgical consultation.1 Although requiring cervical spine clearance. Modern multi- many of the principles of detection and repair are detector CT (MDCT) scanners have revolutionized basic, evolving technology and novel therapeutic trauma imaging and provide a fast, safe, cost- strategies have led to improved patient outcomes. effective, and sensitive means for assessing The goal of imaging studies in the trauma setting is trauma for bone and soft tissue injuries. Further- to define the number and location of facial fractures, more, with the advent of MDCT, facial scans with particular attention toward identifying injuries to can now be performed contemporaneously with functional portions of the face and those with head, thoracic, and abdominal scans, facilitating cosmetic consequence. By understanding common a rapid assessment for trauma patients with fracture patterns and the implications for clinical multiple potential injuries. management, radiologists can better construct clin- MDCT offers excellent spatial resolution, which ically relevant radiology reports and thus facilitate in turn enables exquisite multiplanar reformations, improved communication with referring clinicians. and 3-D reconstructions, allowing enhanced diag- This article aims to provide a review of the imaging nostic accuracy and surgical planning. These aspects involved in maxillofacial trauma and to reconstructions assist in the assessment of frac- delineate its relevance to management.
    [Show full text]
  • Cardiothoracic Trauma
    Moheb A. Rashid, M.D. Moheb CARDIOTHORACIC TRAUMA A SCANDINAVIAN PERSPECTIVE Moheb A. Rashid, M.D. CARDIOTHORACIC TRAUMA CARDIOTHORACIC Göteborg, 2007 ISBN: 978-91-628-7171-0 CARDIOTHORACIC TRAUMA A Scandinavian Perspective Moheb A. Rashid, MD Division of Surgery, Institute of Clinical Sciences Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden Göteborg 2007 “..And if any one saved a life it would be as if he/she saved the life of the whole people..” (Quran S. The Table 005:032) “The wards are the greatest of all research laboratories” (Sir Henry Wade, 1877-1955, Surgeon, Royal Infirmary, Edinburgh) The cover depicts the Papyrus of Hunefer from the 19th Dynasty (1307-1196 BC) showing the deceased (Hunefer) led in by Anubis, and his heart weighed against a feather. Anubits checks the balance while the crocodile (eater) stands ready and Toth records the results. It is believed to be the first picture of the heart. Dedicated to: My Parents Om-Hashem & Abdelhay My Sisters & Brothers in Egypt Christina, Magda, Joseph & Jacob CARDIOTHORACIC TRAUMA A Scandinavian Perspective Moheb A. Rashid, MD, Division of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden. Abstract Background: Trauma in general is a major cause of morbidity and mortality worldwide, and causes more loss of productive years than ischemic heart disease and malignancy together. Cardiothoracic trauma occurs in 60% of multitrauma patients and is 2-3 times more common than intra-abdominal visceral injuries. It constitutes 25% of traumatic deaths and contributes significantly to at least another 25% of these fatalities. Though only about 15% of chest trauma requires operative intervention, a considerable number of preventable deaths occur due to inadequate or delayed treatment of otherwise an easily remediable injury.
    [Show full text]
  • Vancomycin Powder Use in Fractures at High Risk of Surgical Site Infection
    ORIGINAL ARTICLE Vancomycin Powder Use in Fractures at High Risk of Surgical Site Infection Rabah Qadir, MD,a Timothy Costales, MD,a Max Coale, BA,a Alexandra Mulliken, BS,a Timothy Zerhusen, Jr, BS,a Manjari Joshi, MBBS,b Renan C. Castillo, PhD,c Anthony R. Carlini, MS,c and Robert V. O’Toole, MDa Results: Compared with a control group of fractures treated during Objectives: To determine if the use of intrawound vancomycin the same time period without vancomycin powder, the infection rate powder reduces surgical-site infection after open reduction and with vancomycin powder was significantly lower [0% (0/35) vs. fi internal xation of bicondylar tibial plateau, tibial pilon, and 10.6% (58/548), P = 0.04]. Compared with our previously published calcaneus fractures. historical infection rate of 13% for these injuries, vancomycin pow- fi Design: Retrospective analysis. der was also associated with signi cantly decreased deep surgical- site infection (0% vs. 13%, P = 0.02). These results agreed with the Setting: Level I trauma center. matched analyses, which also showed lower infection in the vanco- mycin powder group (0% vs. 11%–16%, P # 0.05). Patients: All fractures operatively treated from January 2011 to February 2015 were reviewed; 583 high-risk fractures were included, Conclusions: Vancomycin powder may play a role in lowering of which 35 received topical vancomycin powder. A previously surgical-site infection rates after fracture fixation. A larger random- published prospectively collected cohort of 235 similar high-risk ized controlled trial is needed to validate our findings. fractures treated at our center from 2007 through 2010 served as a Key Words: vancomycin powder, deep infection, surgical-site second comparison group.
    [Show full text]
  • Best Practices in the Management of Traumatic Brain Injury
    ACS TQIP BEST PRACTICES IN THE MANAGEMENT OF TRAUMATIC BRAIN INJURY Released January 2015 Table of Contents Introduction ............................................................................................... 3 Using the Glasgow Coma Scale ...................................................................... 3 Triage and Transport .................................................................................... 5 Goals of Treatment ...................................................................................... 5 Intracranial Pressure Monitoring ..................................................................... 6 Management of Intracranial Hypertension ....................................................... 9 Advanced Neuromonitoring .........................................................................12 Surgical Management .................................................................................13 Nutritional Support ....................................................................................14 Tracheostomy ............................................................................................15 Timing of Secondary Procedures ...................................................................15 Timing of Pharmacologic Venous Thromboembolism Prophylaxis ........................17 Management Considerations for Pediatric Patients with TBI ................................18 Management Considerations for Elderly Patients with TBI ...................................19 Prognostic Decision-Making
    [Show full text]
  • CW119 Trauma Surgery (Key)
    Trauma Surgery ANSWER KEY CW119 To complete this activity, the participant will need to access and read the Trauma Surgery chapter within the Alexander’s Care of the Patient in Surgery textbook. Rothrock, J.C. (Ed.). (2019). Alexander’s care of the patient in surgery (16th ed.). St. Louis, MO: Elsevier., p. 1092-1118. 1 2 C M S P 3 L L 4 E H E A D 5 6 M F E S 7 A U T O T R A N S F U S I O N N X 8 O N E G A T I V E T R I Y A T 9 10 11 L O S H Y P E R T E N S I O N 12 L I V E R R L A 13 G O L D E N H O U R I M 14 C D A M A G E 15 K I D N E Y ACROSS DOWN 1. The regulatory body that requires surgery centers to be 2. The most common organ injured in blunt force trauma. prepared in the event of natural and man-made disasters is the 3. Trauma patients over 20 weeks gestation should be placed ______________. in the ______________ lateral decubitus position to assist 4. Trauma to this specific area of the body is responsible for half with perfusion to the placenta. of all trauma deaths. 5. An osmotic diuretic used by anesthesia to decrease 7. Due to the potential for high volume blood loss, intracranial pressure.
    [Show full text]
  • Should Trauma Surgeons Perform Neurosurgery in Emergencies?
    Commentary 87 Should Trauma Surgeons Perform Neurosurgery in Emergencies? Paritosh Pandey1 1Consultant Neurosurgeon, Manipal Hospitals, Bengaluru, Address for correspondence Paritosh Pandey, Consultant Karnataka, India Neurosurgeon, Manipal Hospitals, 98, HAL Old Airport Rd, Kodihalli, Bengaluru, Karnataka 560017, India (e-mail: [email protected]). Indian J Neurotrauma 2019;16:87 Trauma is one of the most common causes of death and However, there are many caveats to this approach. First of disability, and the burden of trauma in the community is all, the authors suggest undergoing a 3-year trauma surgery increasing with rising population, vehicles, and other factors. course so that the surgeons can be trained in trauma surgery Even though great progress has been made in the institution including neurosurgery. However, just as neurosurgeons, many of resources, hospitals, and staff in the country, the main of these graduates will also settle down in big universities and issues of undersupply and maldistribution of trained doctors cities and would likely not settle down in areas where there is are unlikely to change. This is true for developed countries low availability of neurosurgeons. If there are such trauma sur- too; however, the condition is especially acute in India, with geons working in an institution that also has neurosurgeons, a huge population, a low number of specialists, and their con- then there would be an unfortunate conflict of interest between centration in urban areas. The need for equitable distribution the two specialists. With 200 to 300 neurosurgical specialists of specialists is a utopian idea, and hence there needs to be passing out every year, it would be better for the neurosurgi- a different idea to improve the availability of services and cal specialists to provide neurosurgical and neurotrauma care manpower in areas where there is a paucity of availability.
    [Show full text]
  • Neurosurgeons, Acute Care Surgeons Or Moms: Who Should Care for the Head Injured? Thomas J
    rauma & f T T o re Esposito, J Trauma Treat 2012, 1.6 l a t a m n r e u n DOI: 10.4172/2167-1222.1000137 o t J Journal of Trauma & Treatment ISSN: 2167-1222 Review Article OpenOpen Access Access Neurosurgeons, Acute Care Surgeons or Moms: Who Should Care for the Head Injured? Thomas J. Esposito* Division of Trauma, Surgical Critical Care and Burns, Department of Surgery, Loyola University Medical Center, Maywood, Illinois, USA Preface Traumatic brain injury is a significant problem in American health care which taps a tremendous number of resources [1]. Neurosurgeons are an integral part of head injury care along with the trauma surgeon, particularly in those cases involving multi system trauma. The intensely trained neurosurgical practitioner dedicated to the care of a broad range of neurologically based conditions, including trauma, is in short supply. Furthermore, like their general surgical colleagues, they are being taxed not only by the glut of head injuries but also by the attendant social, financial and perceived legal disincentives associated with their care. That is why, together, we must find a way to share and reduce the burden of head injury care for both practitioner types and keep both engaged in this vitally needed service to society. It is toward that end that this admittedly provocative and “tongue-in-cheek” essay is offered. Its purpose is not to single out neurosurgeons for castigation, but rather, the intent is to stimulate spirited, yet collegial, honest and productive debate of fundamental issues. It is crucial that these issues be resolved expeditiously in order to move forward and provide much needed access to quality care that is rendered by well trained, committed practitioners who draw pride and satisfaction from their work.
    [Show full text]