Acute care surgery
New surgical division provides superior accessibility and safety.
Maurizio Miglietta, DO, Tracey Arnell, MD, and colleagues treating patients in the new Division of Acute Care Surgery. To ensure the best care possible for patients who require immediate surgery due to acute surgical problems or trauma, the Department of Surgery at NewYork-Presbyterian Hospital/Columbia University Medical Center has established a new Division of Acute Care Surgery.
One of the first such divisions in the nation, and the first in the New York metropolitan area, the Acute Care Surgery Division staffs 'surgeons of the day' who are devoted exclusively to performing emergency general surgery, trauma surgery, and surgical critical care. Sometimes called surgical hospitalists or surgicalists, these in-house surgeons provide rapid assessment and interventions for hospitalized patients with time sensitive problems.
Because acute care surgeons face tremendous variety in the patients they treat, they draw from many disciplines and are adept at a great range of surgical procedures.
The new division provides three main types of care:
- Emergency General Surgery: emergency surgery to treat a wide range of acute problems, such as appendicitis, cholecystitis, intestinal obstructions, hernias, and more.
Advanced monitoring and diagnostic technology allow the division to perform bedside procedures in critically ill patients.
- Surgical Critical Care: unexpected or supplemental surgical intervention for critically ill hospital patients.
For such patients, the Acute Care Division provides continuous monitoring and consultation with other specialists.
- Trauma Surgery: NewYork-Presbyterian/ Columbia cares for about 1,800 adults each year with serious injuries to the neck, chest, abdomen, and extremities.
Care is coordinated with other surgical specialists, including neurosurgeons, orthopedic surgeons, plastic surgeons, and interventional radiologists.
The division also has a one-of-a-kind mobile trauma unit (MTU) which provides advanced operative services and other care at the site of accidents, including treatment of people trapped by collapsed buildings, industrial or subway accidents, or in areas inaccessible due to high-level security.
This on-call team provides emergency services during national security events such as presidential visits to New York City, the papal visit, the United Nations General Assembly, and other diplomatic events.
Maurizio A. Miglietta, DO, Chief, Division of Acute Care Surgery, says that the division is able to provide superior care because it ensures timely surgical assessment and operative management.
"If a patient needs surgery in the middle of the night, we are there 24-7.
Patients receive care faster, and I believe this will lead to better outcomes."
The division may also help patients in less direct, but nonetheless important ways.
"Our presence frees up other specialists and allows them to concentrate on what they do best," he says.
In many cases, Dr. Miglietta says, he acts as something of a puppet master, coordinating patients' care with multiple other services.
"With many physicians becoming more and more specialized, the need for general surgeons has become great," he adds.
Tracey D. Arnell, MD, Vice Chair, Medical Education, and Assistant Professor of Surgery, concurs that the 24/7 availability of the new division improves the quality of medical care in the hospital.
"This accessibility provides an increased safety net to patients because they do not need to wait for specialists to arrive—we are readily available."
While people sometimes expect to be treated by a resident at teaching hospitals such as NewYork-Presbyterian Hospital, patients receiving care from the Acute Care Surgery Division receive treatment by a Board certified surgeon.
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