Care of the critically ill surgical patient
Critical care is now an accepted part of surgical practice, and for many surgeons it is the most stressful part. Questions on critical care are coming up more often in postgraduate surgical examinations. Paul Sutton and P J Livesley explain the idea
Care of the critically ill surgical patient is a relatively new concept from the Royal College of Surgeons. Their course lasts three days and comprises lectures, small group tutorials, and practical exercises dealing with issues relating to critical care. Teaching is done by surgeons and specialists in intensive care. The aim of the course is to provide junior doctors with the skills they will need to manage acutely ill surgical patients when they become registrars, but as yet it is not a prerequisite for entry into higher surgical training. The course incor-porates the need for trauma care beyond the golden hour (the first 60minutes after the onset of an acute illness or trauma), and applies equally to elective and routine patients as well as emergency admissions. The main emphasis is on simultaneous investigation and resuscitation, with the aim of early definitive treatment (figure).
The approach to any acutely unwell patient