title: Acute Care/Trauma Surgeon's role in obstetrical/gynecologic emergencies (The OBCAT Alert).
abstract: BACKGROUND
  Overwhelming hemorrhage or other intra-abdominal complications may be associated with obstetrical or gynecologic (OB/GYN) procedures and may require the surgical training of an Acute Care/Trauma Surgeon. The OB Critical Assessment Team (OBCAT Alert) was developed at our institution to facilitate a multidisciplinary response to complex OB/GYN cases. We sought to review and characterize the Acute Care/Trauma Surgeon's role in these cases.
  
  
  METHODS
  We conducted a retrospective review of all emergency consults during an OB/GYN case at our institution from 2008 to 2015. An OBCAT is a hospital based alert system designed to immediately notify OB/GYN, anesthesiology, Acute Care/Trauma, the intensive care unit (ICU), and the blood bank of a potential emergency during an OB/GYN case.
  
  
  RESULTS
  There were 7±3 OBCAT alerts/year. Seventeen patients required Acute Care/Trauma surgery intervention for hemorrhage. Thirteen patients required damage control packing during their hospitalization. Blood loss averaged 6.8±5.5 L and patients received a total of 21±14 units during deliveries with hemorrhage. There were 17 other surgical interventions not related to hemorrhage; seven of these cases were related to adhesions or intestinal injury. Seven additional cases required evaluation post routine OB/GYN procedure; the most common reason was for severe wound complications. There were three deaths during this study period.
  
  
  CONCLUSIONS
  Emergency OB/GYN cases are associated with high morbidity and may require damage control or other surgical techniques in cases of overwhelming hemorrhage. Acute Care/Trauma Surgeons have a key role in the treatment of these complex cases.
authors.affiliation: Division of Acute Care Surgery and Trauma, Memorial Regional Hospital, Hollywood, FL 33021, USA.
authors.forename: Seong K
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Division of Acute Care Surgery and Trauma, Memorial Regional Hospital, Hollywood, FL 33021, USA.
authors.forename: Eddy H
authors.initials: EH
authors.lastname: Carrillo
authors.affiliation: Division of Acute Care Surgery and Trauma, Memorial Regional Hospital, Hollywood, FL 33021, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Rosenthal
authors.affiliation: Division of Acute Care Surgery and Trauma, Memorial Regional Hospital, Hollywood, FL 33021, USA.
authors.forename: Rafael
authors.initials: R
authors.lastname: Sanchez
authors.affiliation: Division of Acute Care Surgery and Trauma, Memorial Regional Hospital, Hollywood, FL 33021, USA.
authors.forename: Chauniqua
authors.initials: C
authors.lastname: Kiffin
authors.affiliation: Division of Acute Care Surgery and Trauma, Memorial Regional Hospital, Hollywood, FL 33021, USA.
authors.forename: Dafney L
authors.initials: DL
authors.lastname: Davare
keywords: Acute care surgery; Damage control packing; OBCAT; Obstetric hemorrhage; Postpartum hemorrhage