Trauma anesthesia is an overlooked specialty, possibly because traumatic injuries occur sporadically, intermixing erratically with the normal daily work flow. However, the impact of trauma injuries is enormous –Centers for Disease Control data shows unintentional injury is one of the leading cause of death in all Americans, and the leading cause of death in individuals from 1 to 44 years of age. Clearly, trauma anesthesia is a much needed and important part of treating these vulnerable patients.
DHMC is a regional Level I trauma care facility (the only level one trauma center in New Hampshire) with over 1,200 Dartmouth-Hitchcock Advanced Response Team (DHART) helicopter transports each year (over 10,000 during the past 15 years). This service has grown to be an integral part of our emergency services, so much so that we have multiple helicopters in service to cover our service area for the growing population demand. The Trauma Committee is comprised of physicians from General Surgery, Orthopedics, Neurosurgery, Pediatrics, Anesthesiology, and Emergency Medicine as well as representatives from Nursing, Hospital Administration, and DHART, thus providing a multidisciplinary approach to overall trauma management.
Anesthesia residents treat adult and pediatric trauma cases primarily while on call. Both residents and faculty respond to the trauma bay for all high level trauma activations and directly manage the airway and help with resuscitation as needed.
The trauma anesthesia curriculum includes didactics on mechanisms of injury, shock/trauma physiology and socioeconomic impact. Specific objectives include: management of the traumatized airway, burns, hemostasis and uncontrolled hemorrhage, coagulation and fibrinolysis, metabolic derangement resulting from shock, hypothermia and rapid resuscitation, and finally, the impact of activation and release of various mediators of the inflammatory cascade.
In addition to the trauma lecture series, all residents take the ACS – Advanced Trauma Life Support course and function as integral members of the Trauma Team while in the emergency department and operating rooms. Residents participate in our crisis management simulation course, rotate in the ICU on the Acute Care and Trauma service and attend Trauma conference. In addition, residents who so desire can be involved in the monthly Trauma Operational and Process Improvement meetings and can use data collected on trauma patients for research and quality improvement processes.
- Clinical Subspecialties
- Acute Pain Service
- Airway Management
- Ambulatory Anesthesia
- Cardiac and Thoracic Anesthesia
- Neurosurgical Anesthesia
- Non-Operating Room Anesthesia
- Obstetric Anesthesia
- Orthopaedic Anesthesia
- Pediatric Anesthesia
- Post Anesthesia Care Unit (PACU)
- Pre-Admission Testing (PAT)
- Regional (Block) Anesthesia
- Transplant Anesthesia
- Trauma Anesthesia
- Vascular Anesthesia
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