Maintaining vascular trauma proficiency for military non-vascular surgeons

Background Vascular injuries in combat casualty patients are common and remain an ongoing concern. In civilian trauma centers, vascular surgeons are frequently available to treat vascular injuries. Within the military, vascular surgeons are not available at all locations where specialty expertise ma...

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Main Authors: Andrew Hall, Iram Qureshi, Jacob Glaser, Kegan Brumagen
Format: Article
Language:English
Published: BMJ Publishing Group 2020-12-01
Series:Trauma Surgery & Acute Care Open
Online Access:https://tsaco.bmj.com/content/5/1/e000475.full
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author Andrew Hall
Iram Qureshi
Jacob Glaser
Kegan Brumagen
author_facet Andrew Hall
Iram Qureshi
Jacob Glaser
Kegan Brumagen
author_sort Andrew Hall
collection DOAJ
description Background Vascular injuries in combat casualty patients are common and remain an ongoing concern. In civilian trauma centers, vascular surgeons are frequently available to treat vascular injuries. Within the military, vascular surgeons are not available at all locations where specialty expertise may be optimal. This study aims to determine if a visiting surgeon model, where a general surgeon can visit a civilian trauma center, would be practical in maintaining proficiency in vascular surgery.Methods All vascular trauma relevant cases done by any surgical service were identified during a 2-year period at Saint Louis University Hospital between October 1, 2016 and September 30, 2018. These included cases performed by trauma/general, thoracic, vascular, and orthopedic surgery. Predictions on the number of call days to experience an operative case were then calculated.Results A total of 316 vascular cases were performed during the time period. A surgeon on call for five 24-hour shifts would experience 2.1 urgent vascular cases with 95% certainty. To achieve five cases with 95% certainty, a surgeon would have to be on call for 34 24-hour shifts.Discussion A visiting surgeon model would be very difficult to maintain to acquire or maintain proficiency in vascular surgery. High-volume trauma centers, or centers with significant open vascular cases in addition to trauma, may have more reasonable time requirements, but would have to be evaluated using these methods.Level of evidence Economic and value-based evaluations, level II.
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spelling doaj-art-478d64c83ca042d8b7f6810d0d1668852025-08-20T02:49:48ZengBMJ Publishing GroupTrauma Surgery & Acute Care Open2397-57762020-12-015110.1136/tsaco-2020-000475Maintaining vascular trauma proficiency for military non-vascular surgeonsAndrew Hall0Iram Qureshi1Jacob Glaser2Kegan Brumagen3Surgery, 96th Medical Group, US Air Force Regional Hospital, Eglin AFB, Florida, USABiomaterials and Epidemiology, Naval Medical Research Unit San Antonio, San Antonio, Texas, USAAustin Shock Trauma, St. David`s South Austin Medical Center, Austin, Texas, USASurgery, Keesler Air Force Base, Biloxi, Mississippi, USABackground Vascular injuries in combat casualty patients are common and remain an ongoing concern. In civilian trauma centers, vascular surgeons are frequently available to treat vascular injuries. Within the military, vascular surgeons are not available at all locations where specialty expertise may be optimal. This study aims to determine if a visiting surgeon model, where a general surgeon can visit a civilian trauma center, would be practical in maintaining proficiency in vascular surgery.Methods All vascular trauma relevant cases done by any surgical service were identified during a 2-year period at Saint Louis University Hospital between October 1, 2016 and September 30, 2018. These included cases performed by trauma/general, thoracic, vascular, and orthopedic surgery. Predictions on the number of call days to experience an operative case were then calculated.Results A total of 316 vascular cases were performed during the time period. A surgeon on call for five 24-hour shifts would experience 2.1 urgent vascular cases with 95% certainty. To achieve five cases with 95% certainty, a surgeon would have to be on call for 34 24-hour shifts.Discussion A visiting surgeon model would be very difficult to maintain to acquire or maintain proficiency in vascular surgery. High-volume trauma centers, or centers with significant open vascular cases in addition to trauma, may have more reasonable time requirements, but would have to be evaluated using these methods.Level of evidence Economic and value-based evaluations, level II.https://tsaco.bmj.com/content/5/1/e000475.full
spellingShingle Andrew Hall
Iram Qureshi
Jacob Glaser
Kegan Brumagen
Maintaining vascular trauma proficiency for military non-vascular surgeons
Trauma Surgery & Acute Care Open
title Maintaining vascular trauma proficiency for military non-vascular surgeons
title_full Maintaining vascular trauma proficiency for military non-vascular surgeons
title_fullStr Maintaining vascular trauma proficiency for military non-vascular surgeons
title_full_unstemmed Maintaining vascular trauma proficiency for military non-vascular surgeons
title_short Maintaining vascular trauma proficiency for military non-vascular surgeons
title_sort maintaining vascular trauma proficiency for military non vascular surgeons
url https://tsaco.bmj.com/content/5/1/e000475.full
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