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Acute care surgery: The safety net hospital model

2007; Elsevier BV; Volume: 141; Issue: 3 Linguagem: Inglês

10.1016/j.surg.2007.01.004

1532-7361

Ernest E. Moore,

Cardiac, Anesthesia and Surgical Outcomes

Success with the proposed construct of Acute Care Surgery as a solution to the identity crisis of trauma surgery 1 Esposito T.J. Rotondo M. Barie P.S. Reilly P. Pasquale M.D. Making the case for a paradigm shift in trauma surgery. J Am Coll Surg. 2006; 202: 655-657 Abstract Full Text Full Text PDF PubMed Scopus (52) Google Scholar will depend on the defined and accepted scope of practice, specifically the ability to perform complex operative procedures. 2 Moore E.E. Maier R.V. Hoyt D.B. Jurkovich G.J. Trunkey D.D. Acute care surgery – eraritjaritjaka. J Am Coll Surg. 2006; 202: 698-701 Abstract Full Text Full Text PDF PubMed Scopus (51) Google Scholar The history of a surgical discipline dedicated to the care of the injured patient in the United States began in the 1960s with the establishment of civilian trauma centers within county hospitals in Chicago (Freeark), Dallas, (Shires), and San Francisco (Blaisdell). 3 Blaisdell F.W. Development of the city-county (public) hospital. Arch Surg. 1994; 129: 760 Crossref PubMed Scopus (9) Google Scholar During the ensuing 2 decades, trauma surgery became an attractive career, based largely on the advice and support of trauma surgeons who acted as mentors, fostering less experienced surgeons in these types of urban county hospitals. Master technicians, including Blaisdell, Carrico, Davis, Freeark, Lucas, Ledgerwood, Mattox, Shires, and Trunkey, epitomized these guides and teachers. These proclaimed trauma surgeons operated confidently and effectively in the neck, chest, abdomen, and pelvis; they also repaired any injured blood vessel. These surgeons commonly maintained active elective surgical practices while providing trauma coverage. This brief report was written to describe the evolution and current status of the Acute Care Surgery service at the Denver Health Medical Center (DHMC)/University of Colorado Health Sciences Center (UCHSC).