J Trauma
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Our recent experimental study showed that peripheral muscle tissue oxygen saturation (StO2), determined noninvasively by near-infrared spectroscopy (NIRS), was more reliable than systemic hemodynamics or invasive oxygenation variables as an index of traumatic shock. The purpose of this study was to establish the normal range of thenar muscle StO2 in humans and the relationship between shock state and StO2 in trauma patients. ⋯ Decreased thenar muscle tissue oxygen saturation reflects the presence of severe hypoperfusion and near-infrared spectroscopy may be a novel method for rapidly and noninvasively assessing changes in tissue dysoxia.
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Strategies to prevent the extinction of the trauma surgeon have focused on increasing the operative potential by including nontrauma general surgery emergencies. Although providing comprehensive emergent surgical care by the trauma service may seem novel, our institution has embraced this concept for the past 25 years. Recent discussions on the future of trauma surgery stimulated us to review our experience as a possible model for the future trauma and acute care surgeon. ⋯ To resurrect our discipline, we must reclaim and expand our operative potential and be relieved of our excessive night and weekend burden of serving as housestaff for the neurosurgeons, orthopedic surgeons, and interventional radiologists. The trauma surgeon can effectively manage trauma and acute care surgery emergencies including thoracic and vascular conditions. Education of the future trauma and acute care surgeon must include specialty training in thoracic and vascular surgery.
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Reliable, accurate, program-specific data for hospital product lines are often difficult to obtain. The purpose of this study was to determine the impact that trauma center status has on hospital net income when compared with other traditional hospital product lines and services. ⋯ We conclude that, for our institution, the investment in resources necessary to achieve and maintain trauma center status makes economic sense in that the trauma program contributes favorably to hospital net revenue.