One of the growing problems in trauma care is accessing surgical subspecialists when needed. Across the US, it is getting increasingly more difficult to recruit specialists in urology, reconstructive plastic surgery, hand surgery, oral/maxillofacial surgery, and ophthalmology.

This is a challenge for all levels of trauma centers. For Level I centers, it’s primarily a recruitment issue. For Levels II-IV, it becomes a transfer issue. For all levels, the real question is, when do you really need to call them? One reason for the shortage problem is that we tend to call too much, bothering them when they are not needed.

The best practice for trauma centers of all levels is to collaborate with subspecialists and develop a practice guideline that lists commonly encountered clinical problems in their field, along with the consult and follow-up expectations for each. Frequently, a large portion of patients can go home and follow up with the subspecialist as an outpatient.

I’ve prepared several sample practice guidelines for you to use in your conversations with your own subspecialists. Today, I’ll publish my ophthalmology guideline. In the next post, I’ll cover urology. And finally, I’ll review some new guidelines for facial injuries that were recently published.

Here’s the eye guideline. You can download it by clicking on it or using the links below.

Or click this link to download

And yes, another consultant reference card. As I wrote previously. we sometimes overuse our consultants and call then at inappropriate times. So what if we diagnose an injury in their area of expertise at 2 am? Does it need attention or an operation before morning? If not, why call at that ungodly hour?

Let’s use our consultants wisely! I’ve listed most of the common eye diagnoses that trauma professionals will encounter. There is also an indication of what you need to do, and exactly when to call your consultant.

Unfortunately, this one won’t fit on a 3×5 index card that you can keep in your pocket. I’ve included a printable pdf file, as well as the original Microsoft Word file in case you want to make a few modifications to suit your own hospital.

Enjoy!

When to call Ophthalmology reference card (pdf)

When to call Ophthalmology MS Wordfile (docx)

Here’s another in my series of “When To Call” pieces. We sometimes overuse our consultants and call then at inappropriate times. So what if we diagnose an injury in their area of expertise at 2 am? Does it need attention or an operation before morning? If not, why call at that ungodly hour?

Let’s use our consultants wisely! I’ve listed most of the common eye diagnoses that trauma professionals will encounter. There is also an indication of what you need to do, and exactly when to call your consultant.

Unfortunately, this one won’t fit on a 3×5 index card that you can keep in your pocket. I’ve included a printable pdf file, as well as the original Microsoft Word file in case you want to make a few modifications to suit your own hospital.

In my next post, I’ll provide a comprehensive reference for when to call your orthopedic surgeon.

• Reference card: When to call urology
• Reference card: When to call ophthalmology
• Reference card: When to call ortho

Here’s another in my series of “When To Call” pieces. We sometimes overuse our consultants and call then at inappropriate times. So what if we diagnose an injury in their area of expertise at 2 am? Does it need attention or an operation before morning? If not, why call at that ungodly hour?

Let’s use our consultants wisely! I’ve listed most of the common eye diagnoses that trauma professionals will encounter. There is also an indication of what you need to do, and exactly when to call your consultant.

Unfortunately, this one won’t fit on a 3×5 index card that you can keep in your pocket. I’ve included a printable pdf file, as well as the original Microsoft Word file in case you want to make a few modifications to suit your own hospital.

Enjoy!

When to call Ophthalmology reference card (pdf)

When to call Ophthalmology MS Wordfile (docx)