Definition

Emergency surgery is non-elective surgery performed when the patient's life or well-being is in direct jeopardy. Largely performed by surgeons specializing in emergency medicine, this surgery can be conducted for many reasons but occurs most often in urgent or critical cases in response to trauma, cardiac events, poison episodes, brain injuries, and pediatric medicine.

Purpose

Most surgery is elective and is performed after a diagnosis based upon a history and physical of the patient, with differential test results and the development of strategies for management of the condition. With emergency surgery, the team, as well as the surgeon, may have less information about the patient than would ordinarily be required and work under very time-dependent conditions to save a patient's life, help avoid critical injury or systemic deterioration of the patient, or to alleviate severe pain. Because of the unique conditions for urgent acute surgery, operations are usually performed by a surgical team specially trained for management of a critical, or life threatening event.

Acute surgical emergencies include:

• invasive types of resuscitation for acute respiratory failure, pulmonary embolism and pulmonary obstructions
• blunt and penetrating head, chest, abdomen injuries, largely from automobile accidents and gun shot wounds
• burns
• cardiac events, including heart attacks, cardiac shock and cardiac arrhythmia
• aneurysms
• brain injuries and other neurological conditions
• perforated ulcer and appendix, and peritonitis

Description

Emergency surgery can take place in any hospital setting. However, trauma centers or trauma sections of hospitals handle most emergency surgeries. Forty-four states have designated trauma centers, some states with better systems than others. A level 1 trauma center, the most advanced of the trauma center system, is equipped to get the patient to surgery beginning with trained first responders. The system relies on available operating rooms, readily available laboratory personnel, anesthesiologists, x-ray and blood bank access, intensive care nurses, and ward nurses—all trained to take the patient to the operating room within 60 minutes of the incident. If patients are in surgery within an hour they have a 25% chance of survival.