Monday, May 11, 2009


When you have multiple injuries, a multi-disciplinary approach is required; what this seems to mean at my place of work is that all the relevant specialists offer to 'fix their bit' as long as the patient is under someone else's care.

So: when your injuries are:
Minor head injury - no skull fracture, no bleed, no brain injury
Facial contusions - no fractures
No spinal fractures
Laryngeal cartilage fracture, undisplaced, no active intervention required
Subconjunctival haemorrhage, normal visual acuity
Multiple rib fractures, with right pneumothorax, requiring tube thoracostomy
Ruptured oesophagus - at about mid thoracic level
No abdominal, pelvic or long bone injury

Who should be the Speciality in 'overall charge'?

Who should admit the patient?

Ear, Nose, Throat?
General Surgery?

Answers as usual, please... I think they're still arguing about it at work


Anonymous said...

We always admit trauma patients for general surgery for the first 24 hours. After that the arguing starts but with multiple injuries most likely general surgery will stay in charge and coordinate all care.

rlbates said...

I agree with Anonymous.

fallenkshatriya said...

That patient would come under general surgery where i work...the oesophagus clinches it, methinks. (Loooong time lurker, now de-lurking)

DrShroom said...

FWIW he went to CTS - gensurg was a lower GI man, so not interested, but the whole thing involved vast amounts of flail

sandra may said...

My guess would be cardiothoracic- all the others will argue about the care of a chest drain.

Anonymous said...

Trauma Surgery