Possibly stupid question....

[SLUser11]

I was entering cases tonight, and I noticed for the first time that some (or possibly most) burn cases are listed under the category of "Trauma," a xenograft case in this instance.

I've done plenty of burn cases over the years, some emergently and many electively. I've never considered these to be trauma patients, although I guess technically getting burnt to s@#t is extremely traumatic.

Should I be checking the "Involved Trauma" box for these cases? My current practice is to not check that box, which makes sense to me, but I just want to be sure.

To me, it just doesn't fit the category of "Operative Trauma," although I've been wrong before........

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[OTD]

Burns are trauma so I would think you could check the box. I do.

I would also think it would be your descretion, if you have enough trauma then don't check the box and count it as plastics if you need those cases.

I don't think you would be wrong either way, but what do I know.

 

[SLUser11]

Burns are trauma so I would think you could check the box. I do.

I would also think it would be your descretion, if you have enough trauma then don't check the box and count it as plastics if you need those cases.

I don't think you would be wrong either way, but what do I know.

Thanks for the response.

This thread has been viewed 250 times. I'm curious about the other residents on the forum (past or present), WS, JAD, Blade, Castro, Pilot doc, Amy.....what did you guys do? Did you count burns as traumas or not?

I spoke with other residents from my own program, and it seems the general consensus is to not count them as traumas....but I still don't know for sure what the right answer is for sure....

 

[Winged Scapula]

I never did Burns (replaced my Burn Rotation with a Hand/Ortho one) so didn't have any to classify.

 

[surg]

Pretty sure that I didn't include them in my trauma cases, although, in retrospect I probably should have for the ones that were things like MVA with car fire. I don't think people would bug you either way you listed it though.

 

[JackADeli]

...I'm curious about the other residents on the forum (past or present), WS, JAD, Blade, Castro, Pilot doc, Amy.....what did you guys do? Did you count burns as traumas or not?....

Our center was level 1 trauma WITHOUT burns. Having said that the few burns we did get, usually got trauma classified when logging case.


JAD

 

[Pir8DeacDoc]

This thread has been viewed 250 times.

Your thread title doesn't exactly make it clear what it is you want. Certainly a few (myself included) were curious what dumb question you had.

But since I'm not GS I can't really offer much help...

 

[surgres88]

I was entering cases tonight, and I noticed for the first time that some (or possibly most) burn cases are listed under the category of "Trauma," a xenograft case in this instance.

I've done plenty of burn cases over the years, some emergently and many electively. I've never considered these to be trauma patients, although I guess technically getting burnt to s@#t is extremely traumatic.

Should I be checking the "Involved Trauma" box for these cases? My current practice is to not check that box, which makes sense to me, but I just want to be sure.

To me, it just doesn't fit the category of "Operative Trauma," although I've been wrong before........

Short answer, your choice.

We do burns at Shriners and we counted them as TRAUMAs if we did escharotomies or fasciotomies emergently (a little bedside bovie procedure in the burn unit). I have never done a debridement right from the resus bay with a burn. Though I think a fellow intern did this when someone was coated in hot tar and I remember hearing they took him to the OR to get the stuff off of him.

I looked into the ACGME case log system and found these CPT codes related to Trauma/burns (meaning when you select them in the log you can choose it under trauma, just like an ex-lap.) :
15121: STSG 100cm2 to multiple areas
15120:STSG same as above to kids
15101: STSG 100 cm or 1% TBSA
15100: STSG
15004 and 15005: for preparation of burn grafting.

 

[SLUser11]

Short answer, your choice.

We do burns at Shriners and we counted them as TRAUMAs if we did escharotomies or fasciotomies emergently (a little bedside bovie procedure in the burn unit). I have never done a debridement right from the resus bay with a burn. Though I think a fellow intern did this when someone was coated in hot tar and I remember hearing they took him to the OR to get the stuff off of him.

I looked into the ACGME case log system and found these CPT codes related to Trauma/burns (meaning when you select them in the log you can choose it under trauma, just like an ex-lap.) :
15121: STSG 100cm2 to multiple areas
15120:STSG same as above to kids
15101: STSG 100 cm or 1% TBSA
15100: STSG
15004 and 15005: for preparation of burn grafting.

I spoke with some co-residents and my PD, and got a similar response. It sounds like burns can count as an operative trauma or as a plastics case. Obviously, you'd have to use some discretion, although I guess it's really "on your honor" in the end.

What I'm probably going to do is continue to log them as non-traumas. We get plenty of operative trauma, and it feels just a little dirty....

Plus, none of the other PGY-3s seem to be doing it, and we all know what happens if there's a significant discrepancy in your operative numbers.

 

[ESU_MD]

I logged 3/4 of my burns as trauma cases, the rest as plastics.

Interestingly, I spent ALOT of time on my oplog- the day I finished residency my access got cut off, my PD gave me a printout and that was that.

Does anyone ever request to see this info for credentialing, etc?? what if you didnt get a printout- does the data still exist in cyberspace somewhere?

 

[Winged Scapula]

ESUMD...

I have privileges at 4 hospitals and 3 surgery centers and no one has ever requested a log EXCEPT for "special stuff" - ie, sentinel node and stereotactic biopsies (ie, these are outside of general surgery privileges). They just send a request to your PD and ask if you are trained in the procedures you requested, AFAIK.

That said I still keep a log (of sorts...when I remember) just in case it ever comes down to that.

 

[SocialistMD]

They just send a request to your PD and ask if you are trained in the procedures you requested, AFAIK.

Our housestaff gets requests from hospitals from time to time for this sort of thing on our former residents. They have to keep the data for at least five years for ACGME purposes, and I imagine most keep it for longer than that.

 

[Dimoak]

what if you didnt get a printout- does the data still exist in cyberspace somewhere?

Some facilities will keep the data in some sort of off-site storage. It may not be a mouseclick or two away, but in some cases it's retrievable if someone is looking for it.

 

[Winged Scapula]

When your program submits all of your info to the ABS to determine BE included will be your case logs. So the data exists not only in your copy but at ABS and in your residency program.

All of the credentialing paperwork I've seen states explicitly that if you are 5 years or more out of residency that you do not have to provide data from residency. If necessary hospitals can provide you with case logs.

 

[maxheadroom]

I'll just add a little note about case logs (as I'm currently finishing mine). Once your log is complete, make sure to have an electronic version of it backed up in multiple places. The ACGME says that you won't have access to it after it has been submitted. Your program should keep some sort of backup (as your PD will have to send letters confirming your completion of residency in support of credentials every time you apply for the rest of your career), but you should have it backed up in multiple places. I have multiple backups that have PDFs of licenses, DEA info, transcripts, diplomas, USMLE score reports, and the most recent query to the National Practitioner Databank. In three weeks, I'll add a copy of my op log to those backups.

While you might not need your case log when you apply for privileges ten years after you finish residency, the first couple of places where you practice will almost certainly want to see it.