General surgery will generally be at the head of trauma management. However this doesn’t mean that they will always be at the head of any operative trauma, though they’ll still continue to manage or co-manage the patient if another service operates on them. They’ll generally be the ones doing the secondary and teritiary surveys, and occasionally primary. They’ll also likely be involved in calling other services.
Ortho is involved in a lot of trauma, and will be called upon to manage things like broken extremities (closed reduction vs operation vs both), pelvic fractures (after they’ve been stabilized with a binder), compartment syndrome, and spine trauma.
Neurosurgery will be involves with any head/neck/spine trauma. Skull fractures, any blood inside the skull, spine trauma (similar to ortho, though neurosurgery does way more spine overall), etc all of these will go to neurosurgery and a lot of it is operative.
EM will often receive the patient and do the primary survey and occasionally secondary depending on the institution or situation. They’ll get trauma surgery involved very early and then help stabilize and get other services involved too but don’t participate in long term trauma management after initial stabilization.
Anesthesia is involved in anything trauma related that requires an operation and will sometimes co-staff trauma ICUs with trauma surgeons.
Urology, OMFS, and ENT can be peripherally involved with trauma depending on injuries to their systems (ENT for airway issue, ENT or OMFS for facial stuff, and urology for bladder/urethral injuries) but will almost never be primary on trauma patients.
Plastics will sometimes be called for hand or facial trauma depending on the institution, but will be a consultant more than anything and generally less involved than OMFS or ortho.
Neurology will staff neurocritical care units that neurosurgery trauma patients may end up in and will see TBI patients on follow up, but otherwise won’t have too much direct involvement.
PM&R will see long term follow up trauma patients that require rehabilitation but are not involved in initial management.
So basically if you like initial trauma management, I would go with one of the following:
EM: immediate stabilization, non-operative, quick handoff
General surgery: immediate stabilization, operative and non-operative, management throughout hospital stay
Neurosurgery: operative and non-operative management after immediate stabilization by one of the two above with rapid initial evaluation for brain/spine trauma
Ortho: operative and non-operative management after immediate stabilization by the above with rapid initial eval for MSK/spine trauma
Anesthesia: periop and critical care management as well as airway and potentially initial stabilization (ABCDEs) in some cases
