A Trauma Surgeon's Daily Schedule

A trauma surgeon is a specialist surgeon who focuses on the diagnosis and conservative or surgical management of traumatic injuries. These injuries would be managed in an emergency situation and include those sustained in major vehicle accidents, stab and gunshot wounds and deep lacerations, usually limited around the abdominal area, as well as generalized burn wounds.  

Trauma surgeons will be in charge or and work at specialised trauma units, but there are those who will also work at acute hospitals where they will be consulted to provide medical care for patients who have sustained traumatic injuries needing specialized care. Trauma surgeons will assist casualty doctors with patients who have severe traumatic injuries.

Casualty doctors will have ATLS (advanced trauma life support) credentials that allow them to initially manage some important life-threatening conditions that include a pneumothorax, cardiac tamponade, tension pneumothorax, flail chest, haemothorax and acute haemorrhage before a trauma surgeon can take over the management of the patient. These patients would therefore be stabilized and managed either non-surgically or surgically.

Training

A doctor wanting to specialise in trauma surgery needs to complete certain training criteria. This includes completing their 5-6 year undergraduate medical degree to become a qualified doctor and completing a 1-2 year internship phase where the doctor works in various medical and surgical departments.

When these programmes are completed, the newly qualified doctor may then be allowed to specialise. The doctor will then complete a 5 year residency training programme in general surgery and carry on to train for another 2 years in a fellowship programme for trauma surgery.

Responsibilities of a Trauma Surgeon

The main responsibility of a trauma surgeon is to initially resuscitate and stabilize the patient, and later evaluate and manage them accordingly. The trauma surgeon who is in charge of the unit also leads the trauma team. This team consists of trained nursing personnel and physicians in the trauma residency programme.

Trauma surgeons are responsible for managing most injuries to the neck, chest, abdomen and extremities. These surgeons will also treat most musculoskeletal trauma by stabilizing the patient before referring them to orthopaedic surgeons, and brain trauma patients will also be initially managed before being referred to neurosurgeons if they are not immediately available.

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Trauma surgeons must be familiar with various general thoracic, surgical and vascular procedures. In an emergency situation there is often very little time and incomplete information of the patient available to the trauma surgeon, and they must be able to make immediate and complex decisions. These specialist surgeons must be proficient in all aspects of intensive care medicine or critical care medicine as they may be in charge of surgical or trauma intensive care units. 

Trauma surgeons are responsible for prioritizing patients presenting to trauma centres who have multiple organ system injuries. The care of these patients may require numerous diagnostic studies and procedures to be performed and the trauma surgeon will be responsible for planning the general treatment plan. This process begins as soon as the patient arrives in the casualty department, where they are triaged according to the severity of the injury sustained, and continues to the operating theatre, ICU and general ward. 

The Daily Schedule Of A Trauma Surgeon

The trauma surgeon will consult with their patients who are admitted in the general wards and the surgical or trauma ICUs in the hospital. This will be done 1-2 times a day depending on the patient's health status and medical needs. The patients will be managed conservatively or surgically depending on the injuries they sustained, and will be discharged home when they are clinically stable or transferred to a rehabilitation hospital to continue with their conservative management.

Trauma surgeons are based either in their own offices in the hospital or they have an office in the specialized trauma unit. This allows them to respond quickly to an emergency situation when they are needed. Trauma surgeons are consulted by other specialists if they feel that their services would benefit the patient, but most of the time they are called upon by emergency room staff and doctors to attend to a traumatic injury on a patient. These injuries would be described as potentially life-threatening ones that require immediate management.

These specialists also provide on call services for the hospital during after hours and on weekends where they are consulted regarding traumatic injuries. Along with those mentioned already, some other emergency situations and procedures that a trauma surgeon is exposed to and performs, respectively, include airway obstruction where a crycothyrotomy would be done, acute intracranial haemorrhage and performing burr-holes in the skull, intrathoracic bleeding due to a severed pulmonary vessel where a thoracotomy needs to be performed and a pelvic fracture resulting in blood loss requiring external fixation on the fracture. 

Monday

The trauma surgeon will deal with any administrative issues such as attending meetings and sorting out office related tasks.

The trauma surgeon will begin consulting with patients once the mentioned issues have been dealt with. The specialist will usually consult with patients who are following up after they received treatment for their injuries. The surgeon will assess the patient and decide whether further surgical, non-surgical or conservative management is still needed, whether the patient only needs further rehabilitation or whether the patient can be discharged from the doctor's care. 

Tuesday

The trauma surgeon will spend this day operating in theatre. The procedures can be elective ones such as crycothyrotomies for patients needing mechanical ventilation, or emergency ones such as performing laparotomies on patients with gunshot wounds.

Wednesday

The trauma surgeon will spend the morning following up with post-surgical or post-management patients and the afternoon will be spent in theatre operating on elective and emergency cases.

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Thursday

The morning will be spent operating and the afternoon will be used to train undergraduate medical students and postgraduate surgical and trauma clinical assistants.

Friday

The trauma surgeon will spend this day consulting with patient, in the office or in the emergency room, and performing procedures in the operating room.

The afternoon will be used to finalise any unfinished administrative tasks and the work week can then end.