The Surgical PA practicing in Trauma Surgery is trained to manage a broad range of medical and surgical conditions. In the current era, PAs working in a trauma environment should either have completed a post-graduate surgical residency in General Surgery or Emergency Medicine, or have at least two years of experience in either General Surgery or Emergency Medicine.

Because the spectrum of trauma surgery encompasses many organ systems, the trauma surgery PA must be knowledgeable about a wide range of pathophysiology as well as how the injuries sustained should be prioritized. Trauma remains the leading cause of death in the first four decades of life and is surpassed only by cancer and atherosclerosis as the major cause of death in all age groups.

Approximately 60 million injuries occur annually in the United States. Roughly one-half, or 30 million of these injuries require medical care, and 3.6 million require hospitalization. Nearly nine million of these injuries are disabling - 300,000 permanent disabilities and 8,700,000 temporary disabilities. For this reason, it is necessary that Trauma PAs have compassion for individuals involved in a trauma and are able to deal with the social issues that subsequently arise.

The role of the Trauma Surgery PA usually involves all aspects of patient care. For example, the Trauma PA may be the first member of the trauma team to evaluate the trauma victim and institute immediate therapy. A Trauma PA may also play an active role in assisting in the operating room, as well as the post-operative management and following the patient through the critical care portion of their recovery. This PA will often attend to the patient closely on the hospital surgical ward. In most Trauma Centers, patients are followed up in the Trauma surgery clinic where the PA plays a significant role in providing a degree of continuity of care not usually possible with surgical residents. The Trauma Surgery PA will also be responsible for making rounds with the attending surgeon and filling her/him in on pertinent issues involving patient care. Other responsibilities that arise include being able to deal with patient calls after hospital discharge or general follow-up questions. This may include triaging patients to the ER or to the trauma clinic.

Surgical Ward Responsibilities include: ordering and interpretation of appropriate laboratory and diagnostic studies, collation of information, requesting and following up on recommendations of consultants (usually after discussion with the surgeon), assessment of fluid and electrolyte balance; management and removal of tubes and drains; formulating a differential diagnosis and confirming or refuting the options according to the physical exam and data obtained; identifying and prioritizing surgical, medical, and psychosocial problems; and ordering and renewing appropriate medications.

The Trauma Surgery PA is expected to be able to manage patients undergoing a broad range of procedures including Orthopedic, ENT, OMFS, Urology and Vascular. The PA must know when appropriate consultation is warranted and speak with that service. The flexibility and the adaptability of the Trauma Surgery PA make her or him the obvious choice to assist the surgeon in all aspects of caring for the trauma patient. As always, the Physician Assistant works under the supervision of the Trauma Surgeon. It is the Trauma Surgeon who should be the judge of the capabilities, skills and limitations of the Physician Assistant.

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