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DIVISIONS | TRAUMA, CRITICAL CARE & EMERGENCY SURGERY

Contact Information for the Division of Trauma, Critical Care and Emergency Surgery

Welcome to the Division of Trauma, Critical Care and Emergency General Surgery, a major component of the academic mission of the division 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
imageWhile 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. Emergency Room triages and resuscitation, emergency room imagenutritional 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, Division Chair
Division Chairman

Dr. Rao R. Ivatury, Division Chair, 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 including a textbook on 'Penetrating Trauma.'

Clinical Programs and Patient Care
The Division consists of five full-time trauma surgeons, a nurse-manager/trauma coordinator, two 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.

VCU Critical Care HospitalCritical 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 VCU Medical Center 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.

imageThe 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-FlightEMS helicopter 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.


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 violence 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 7:30 - 9:00am, Learning Center, Main 1
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
Rahul J. Anand, MD
Therese Duane, MD
Paula Ferrada, MD
Ajai Malhotra, MD
James Whelan, MD
Julie Mayglothling, MD
Martin Mangino, PhD

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last updated: 7/7/11
 
 
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