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Trauma Rotation

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Suffolk County Police helicopter ambulance coming in for landing at University Hospital.

The Stony Brook Trauma Center is the only adult/pediatric Level I trauma center in Suffolk County with verification from the American College of Surgeons (read more). Serving a population of more than 1.5 million residents, the trauma service at Stony Brook, provided by the Trauma, Emergency Surgery, and Surgical Critical Care Division, treats approximately 1750 injured patients annually. In addition to direct admissions, University Hospital consults on and receives transfers of complex, critically injured patients from all points in Suffolk County, and every community and Level II trauma hospital in the region. Stony Brook also serves as EMS control for all of Suffolk County’s ground and air ambulances.

The trauma service at Stony Brook has been recognized by multiple state and federal health care agencies as providing among the highest level of care to injured patients in the country. According to the Agency for Healthcare Research and Quality, Stony Brook’s trauma service is in the top 4% of trauma centers nationwide, with the lowest mortality of any hospital in the United States in treating pedestrian trauma.

In addition, University Hospital has been recognized as second in the United States for saving very high-risk trauma patients. The New York State Department of Health has reported that University Hospital is one of four (of 40) state trauma centers in which the risk-adjusted inpatient mortality rate is significantly lower than the statewide mean (the second hospital ever to repeat this achievement in two consecutive reports).

The trauma service is active 24 hours a day, seven days a week, 365 days a year. Surgical residents rotate on the service during their PGY-1, PGY-3, and PGY-4 years. The night float service functions as the trauma team after 6 PM. Trauma attendings rotate on a weekly basis for daytime service coverage. Attending coverage at night is based on a daily rotating schedule.

The trauma team also includes nurse practitioners, physician assistants, and nurse coordinators. Before joining the trauma service, residents complete courses in advanced cardiac life support (ACLS) and advanced trauma life support (ATLS). An up-to-date trauma manual for the Stony Brook Trauma Center is provided for each participant of the trauma team.

Residents rotating on the trauma service can expect a broad experience in the evaluation and treatment of critically ill and injured patients. In addition to handling traumatic injuries, the Trauma Service is responsible for evaluating and treating burn injuries and general surgery emergencies.

Dr. Marc J. Shapiro (second from left) with trauma team.
Dr. Marc J. Shapiro (second from left) with trauma team being filmed at Stony Brook by The Learning Channel for two stories focusing on trauma care and "starring" our Level 1 trauma service.

Residents on this service are responsible for the pre-operative, intra-operative, post-operative, and non-operative care of trauma, burn, and general surgery patients. The trauma team is responsible for all aspects of patient care from the time the patient is evaluated in the emergency room to the time of discharge from the hospital.

The attending traumatologists provide all aspects of patient care, both operative and non-operative. A weekly outpatient trauma clinic is staffed by all members of the team, including attendings, residents, medical students, and nurse practitioners. The clinic provides important follow-up care for injured patients, and serves as a valuable teaching environment for residents and medical students rotating on the service.

In addition to a busy clinical experience, the Trauma Service is committed to numerous research endeavors and provides residents enriching opportunities for engaging in research. The basic science research laboratory is focused on elucidating the physiologic mechanisms involved in the pathogenesis of shock, systemic inflammation, and hemorrhage.

The laboratory receives both extramural and intramural research funding, and consists of dedicated research staff along with surgery residents, medical students, and college students. Results from the laboratory have been presented at both national and international conferences, and published in high-impact peer-reviewed journals.

A trauma clinical research group is involved in both prospective and retrospective studies examining multiple aspects in the care of trauma patients. The clinical research group also has dedicated research staff, along with attending, resident, and medical student participation. Results of the efforts of the clinical research group have been presented at numerous national trauma meetings, and published in high-impact trauma and surgery journals.

Residents are strongly encouraged to participate in research during their time with the Trauma Service and throughout their residency education.

Residents can expect to be actively taught on a daily basis by team members. Morning attending rounds provide an optimal context for resident education and patient care. A weekly trauma conference includes discussions of recent morbidities and mortalities, didactics, formal lectures, a journal club, and research presentations. Trauma cases are also reviewed at the department level at the weekly departmental morbidity and mortality conference.

Resident performance on the trauma service is evaluated using a core competency system. The six core competencies include medical knowledge, patient care, interpersonal and communication skills, professionalism, practice-based learning, and systems-based practice.