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DIVISIONS |
TRAUMA, CRITICAL CARE & EMERGENCY SURGERY
 A major component of
the academic mission of the Division
of Trauma, Critical Care and Emergency
General Surgery is to foster the development
and maturation of the General Surgeon.
This development not only involves clinical experience
but also an exposure to and understanding
of the basic physiological principles
of surgery.
HOUSESTAFF
 While the faculty
members in the Division have the ultimate
administrative and legal responsibility
for the patients, the division’s
philosophy places strong emphasis on
the individual resident’s
sense of responsibility, his/her participation
in unit teamwork and the leadership capabilities
of the Chief Residents. The housestaff
are responsible for organizing and conducting
weekly didactic teaching conferences.
In addition, the housestaff
have a primary participatory role in
over 95% of the operations done
by the service, which average 1500 yearly.
 Emergency Room triages
and resuscitation, nutritional and metabolic
management, and direct participation
in critical care are other experiences
included in the divisional rotations.
Only through direct participation in
patient care activities can surgical
maturation occur.
Ample opportunity to
develop organizational and clinical skills
exists as our patient admissions are
exceeded by the four major Departments
of Surgery, Medicine, Pediatrics and
Obstetrics (in that order).
Dr.
Rao R. Ivatury is the Division Chair. Dr. Ivatury attended
the Andhra Medical College in Visakhapatnam,
India and completed his surgical residency
at the All India Institute of Medical
Services in New Delhi, India and another
surgical residency at Mercordia-Lincoln
Hospital in the Bronx, New York. He is an internationally
recognized authority in trauma and critical care and
has authored or co-authored over 130
manuscripts dealing with
trauma and critical care issues and
a textbook on 'Penetrating Trauma.'
 Clinical Programs and Patient Care
The Division
consists of four full-time trauma surgeons,
a nurse-manager/trauma coordinator,
two and a half trauma registrar nurses,
a trauma social worker, and part-time
support for a psychologist studying the
epidemiology of penetrating trauma.
The
housestaff on this service include a
PGY V, VI and two PGY I residents.
The trauma section will work in close
collaboration with the Department
of Emergency Medicine.
Critical Care
Dr. Ivatury
directs the 12-bed Surgical/Trauma
Intensive Care Unit with an average
of 1400 admissions per year. These
Units are staffed with two PGY II
and one PGY I surgical housestaff,
and one PGY II anesthesia houseofficer.
During these ICU rotations, there are
many opportunities for resuscitation
and management of critically ill surgical
patients working directly with ICU
attendings certified in Critical
Care, anesthesia residents, medical
students and superb ICU Critical
Care nurses.
Responsibilities
include: helping the surgical team
with daily patient management, reading
assignments and teaching rounds.
The
resident supervises or performs central
line placement and right heart catheterization,
percutaneous endoscopic gastro-jejunostomy
(PEG-J), and flexible bronchoscopy.
The resident will also assist in
fluid, ventilator management and
nutritional care of critically
ill surgical patients. This rotation
prepares residents to assume the
full care of the patient with multiple
system problems emphasizing cardiovascular,
pulmonary and nutritional intervention.
Emergency Department
The emergency rooms at Virginia Commonwealth
University's Medical College of
Virginia Hospitals comprise one
of the largest emergency service
areas in the country (46,000 square
feet) with 117,000 visits annually.
Emergency Services is composed
of four separate but adjoining
emergency rooms — Acute
Medicine; Acute Surgery/Trauma;
Child/Adolescent; OB/GYN.
The Department
of Emergency Medicine has been established
with a full cadre of dedicated, fully
trained Emergency Room Physicians. During
their first year, surgical interns spend
one month rotating through Emergency
Services, which provides an outstanding
experience in trauma, evaluation
of abdominal pain, suturing, treatment
of severe medical problems, and cardiopulmonary
resuscitation. During the JAR year,
the resident spends an additional
month in the Surgery/Trauma ER.
 EMS Med-Flight
As part
of the emergency medical services system
in Virginia, Med-Flight is an air transport
service provided by the Virginia State
Police in cooperation with the Virginia
Department of Health. Patient services
include: on-scene response, emergency
room transfer, inter-hospital transport
and MEDEVAC rescue. A total of 262 patients
were transported to VCU's MCV Hospitals
from July 1996 through June 1997.
RESEARCH
OPPORTUNITIES
The areas of research
in which a house officer can participate
reflect the clinical interest of the
faculty members. These areas include:
sepsis, shock, abdominal compartment
syndrome, trauma, burn injury, nutrition
and gastrointestinal physiology. Available
approaches include studies of mediators
of the injury response, implication of
free oxygen radicals in tissue injury,
mechanisms of lung injury, pre-hospital
trauma care, trauma resuscitation and
injury prevention.
CONFERENCES
M&M Conference
- Tuesday's 1:00-2:00pm, Main 9 Conf Room
Weekly case presentations, discussion,
and literature review by surgery residents
with radiology and medicine input.
Trauma Conference -
Wednesday's 7:30am, Main 9 Conf
Room.
Weekly case presentations, discussion,
and literature review by surgery residents
in collaboration with trauma attendings
and emergency room physician attendings.
FACULTY
Rao R. Ivatury, MD Chairman
Michel Aboutanos, MD
Therese Duane, MD
Ajai Malhotra, MD
Martin Mangino, PhD
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