Emergency Surgery in Romania - Present and Perspectives!

Traumatic injuries represent the most common cause of death in the younger population under age 40. Nowadays we are facing an increasing mortality rate among trauma patients. Many of the deaths take place in the pre-hospital setting, within minutes, usually at the site of the accident. These can be avoided by national promotion and implementation of preventive measures. The second peak of mortality for injured patients, according to the classical model proposed by Donald Trunkey, occurs within the first hours and represents 30% of deaths. These patients are highly dependent on functional trauma systems, their rescue being possible by a 'scoop and go' policy of prehospital care and specially designed trauma centers. For these patients, we have the 'platinum ten minutes' and the 'golden hour', during which the hemorrhage should be stopped. These two intervals of time suggest the level of performance required for a modern trauma system. There is no doubt that worldwide, surgery is going to subspecialization, significant economic resources being dedicated to such units. On the other hand, the national policies fail in offering enough high-quality trauma and acute care surgeons. Currently, young surgeons are managing trauma and other acute patients, with major anatomical and physiological disturbances, just because of a contractual obligation.

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