Someone told me today that to log something as a "trauma non-op" it has to be a real trauma, ie. unstable, penetrating trauma, etc.
I was under the impression that anything that causes the trauma team to be activated can be logged as a Trauma Non-op by the person running the trauma, even the b.s. traumas like the infamous 'fall from standing.'
Thoughts?
Perhaps your source was confusing the required patient care categories of ICU and non-op trauma? While the requirements from the ACGME are vague, I do not believe that non-op trauma has to be anything more than someone cared for by the trauma team.
You are required to have 30 trauma cases, of which non-op is a defined category, however, these will obviously count toward patient care rather than defined operative categories:
http://www.acgme.org/acWebsite/downloads/oplog/440CatMin.pdf This was an obvious attempt to recognize that although surgery residents are required to have some trauma exposure, not all hospitals, even Level 1 trauma centers, are in the operating room frequently. Of note, if you can convince your Ortho or Neurosurg colleagues to let you do some of their cases, those you can count as trauma-operative!
What was suggested to me was that, for ease, use the ICU patients - thus, I would log the required 20 ICU patients with multi-system needs (whether they were trauma or not) and then went on to log all other ICU patients that were trauma and were at least initially non-op (the system does not require that the patients you log in the non-op trauma category NEVER have surgery, only that the management is largely for non-operative complications of their injury), as the non-op trauma patient care. Just remember you cannot code the same patient, on the same day, in two or more categories (ie, you can't make someone a non-op trauma and an ICU category).
While there is no requirement that I can find either on ACGME or ACS sites (or in any of my literature from residency) that states non-op trauma must be penetrating or unstable, etc., there is no reason, even in the most rural or suburban hospitals, that you cannot get the minimum number of trauma patients over 5 years. So I don't see a reason to log the "fall from standing" but I also don't see any requirement that you can't.
