Trauma, Critical Care, and Emergency Care Anesthesiology: A New Paradigm for the “Acute Care” Anesthesiologist?
Anesthesiologists have an opportunity to meet the grow- ing needs of hospitals in providing care to critically ill, injured, or emergency care surgical patients. Acute care anesthesiology would encompass pre-, intra-, and post- operative care of the critically ill surgical patient, expand the scope of anesthesiology, and contribute to improv- ing the safety and quality of patient care. Although no data currently examine the in uence of the acute care anesthesiologist on outcomes in this patient population, it is not unreasonable to believe that a model similar to that for the acute care surgeon would contribute to bet- ter patient care. The most recent data suggest that ACS is a independent predictor of death and major complica- tions when compared with non–acute care surgery cases with a similar case mix.28 Thus, we need to explore the added value of anesthesiologists: Would an acute care anesthesiologist contribute to better patient outcomes? The specialty of anesthesiology should explore the value of the trained acute care anesthesiologist in this model, possibly using data from the AQI NACOR registry. In our opinion, the acute care anesthesiologist model represents an opportunity for further expansion of the role of anes- thesiologists into the “perioperative surgical home care” model of patients hospitalized for nonelective surgical procedures.