title: Simultaneous multisystem surgery: An important capability for the civilian trauma hospital.
abstract: Head injury commonly presents in association with torso or limb injuries, especially in blunt trauma mechanisms. Stopping life-threatening thoraco-abdominal hemorrhage and preventing secondary brain injury are time critical priorities. Although simultaneous operative management by multiple teams has been common practice in the recent wars in Iraq and Afghanistan, simultaneous surgery is rare in most civilian settings. Nevertheless, situations arise whereby simultaneous craniotomy and chest or abdominal surgery is necessary to prevent mortality or reduce severe morbidity. We discuss two recent cases at our level one trauma centre, the challenges that surgeons and the operating room staff face and propose that with appropriate planning this surgical capability can be integrated into the systems of contemporary advanced trauma units.
authors.affiliation: Department of Neurosurgery, The Alfred Hospital, Melbourne, Australia. Electronic address: justinmurraymoore@gmail.com.
authors.forename: Justin M
authors.initials: JM
authors.lastname: Moore
authors.affiliation: Department of Neurosurgery, The Alfred Hospital, Melbourne, Australia.
authors.forename: Piers A W
authors.initials: PA
authors.lastname: Thomas
authors.affiliation: Trauma Service, The Alfred Hospital, Melbourne, Australia; Department of Surgery, Monash University, Melbourne, Australia; National Trauma Research Institute, Melbourne, Australia.
authors.forename: Russell L
authors.initials: RL
authors.lastname: Gruen
authors.affiliation: Department of Neurosurgery, The Alfred Hospital, Melbourne, Australia.
authors.forename: Patrick
authors.initials: P
authors.lastname: Chan
authors.affiliation: Department of Neurosurgery, The Alfred Hospital, Melbourne, Australia; Department of Surgery, Monash University, Melbourne, Australia; National Trauma Research Institute, Melbourne, Australia; Department of Surgery, F. Edward Hebert School of Medicine, Uniformed Services University of The Health Sciences (USUHS), Bethesda, MD, USA.
authors.forename: Jeffrey V
authors.initials: JV
authors.lastname: Rosenfeld
mesh_terms: D000328:Adult; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D013514:Surgical Procedures, Operative / Q000379:methods*; D014193:Trauma Centers
keywords: Craniotomy; Laparotomy; Simultaneous surgery; Surgical risk; Trauma