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Role of PAs on Trauma Team


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Hello all!

 

I work as an ER tech in a large community hospital that is a level two trauma center. Additionally, I am a 19 year old pre-PA student. I was talking to one of our surgical PA's today and he said that he is leaving our hospital to become a trauma PA at an academic medical center that is a level one trauma center in another state. This got me thinking:

 

What roles do advanced practitioners typically play on trauma teams? Can they lead the resuscitation with attending supervision? Does this depend on the type of facility (i.e. academic vs community)?

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Plenty of level 1 trauma centers use PAs. Where I worked as a tech had a few. I am currently rotating at an academic level I that has one and an NP and are looking to add more in the future. The PAs do everything from seeing patients on the floors, doing procedures, to occasionally running traumas if the residents or attendings are not available or tied up. Fun times for all involved.

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This is great to hear that trauma centers are utilizing PAs. Hopefully it is to their full potential and license. I find it hard to know which hospitals are really looking to incorporate PAs into their trauma service and which just want to stick us in Fast Track.

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This is great to hear that trauma centers are utilizing PAs. Hopefully it is to their full potential and license. I find it hard to know which hospitals are really looking to incorporate PAs into their trauma service and which just want to stick us in Fast Track.

I hear ya. In my experience looking for my first job, I found that short of some inside info, you can only really figure this out when you are physically in the department for an interview. The job I took initially looked like a fast track type of place, but ended up being the opposite.

 

PA's are in high demand and you will be surprised what kinds of jobs will be willing to hire a new grad, especially one with good prior HCE in a related field. Yet another reason to not skimp on the HCE on the front end.

 

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This is great to hear that trauma centers are utilizing PAs. Hopefully it is to their full potential and license. I find it hard to know which hospitals are really looking to incorporate PAs into their trauma service and which just want to stick us in Fast Track.

At my facility, only ED PAs are assigned to fast track patients. Only MD/DO would treat critical patients that are admitted to the ED. But in an event of a trauma, there is a designated team of MD and PA that response. Moreover, xray, pharmacy, nurses, and tech from the ED would swarm to assist the MD and PA.
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^^^ that's even more confusing that PAs are not utilized for critically ill patients but they're allowed to be involved in the trauma response. Are they on the rapid response of the Code Blue team?

Only MD/DO and a tech (sometimes) respond to a code blue. When rapid response is called, there is a separate staffing for that team (I'm not sure on the manning).

 

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  • 2 weeks later...

One thing to think about is that it is very program specific.  At level one trauma centers there are usually a boat load of surgery residents.  So you can imaging where the PA fits in.  If there is a procedure it will most likely go to the resident.  If there is a surgery it will go once again to the resident.  If there are a boat load of discharge summaries, progress notes, admit notes, or follow up clinic then that usually goes to the PA.  Again, this is program specific.  Some have PAs that do quite a bit and help train the residents.

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^^^ that's even more confusing that PAs are not utilized for critically ill patients but they're allowed to be involved in the trauma response. Are they on the rapid response of the Code Blue team?

Not necessarily. Many times the ED and trauma teams are completely separate. In the EDs I've been with, the PAs/docs are employed by a private group whereas the trauma team (both docs and PAs) are employed thru the hospital

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Not necessarily. Many times the ED and trauma teams are completely separate. In the EDs I've been with, the PAs/docs are employed by a private group whereas the trauma team (both docs and PAs) are employed thru the hospital

That is how it worked at my previous job. Trauma would get activated and come from their hideout on a different floor. ED and Trauma were a completely different service.

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Guest JMPA

As a PA at a level 1 trauma center i can speak from experience. the ed team was completely seperate. the trauma team was made up of trauma/general surgeons and trauma/general surgical PAs. we responded to the er from all creavices of the building. when any single member of the team arrived they assumed lead over the er team. when a more experienced member arrived they would take over. procedures were performed by first arrival on a emergent basis. all members of the trauma team were expected to know trauma protocol and be competant with their skills.

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Guys where are the Trauma PA jobs? How does one prepare to be a Trauma PA rather than an EM PA? I know MaryFran's program had a cc/trauma residency, Hurley in Michigan and maybe the one in Utah. Are there any more?

take a look at www.appap.org

any residency called trauma/surgery/critical care would get you there.

downside to those jobs is the hrs. My local level 1 will hire new grads as trauma pas, work them 80 hrs/wk for a year, and when they quit  the process begins again.only 2 pas have stayed more than 2 years. they are studly.

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A level I trauma center must have, among a long list of other criteria, a trauma surgeon in house at all times.  This means that while the PAs may do a lot of the procedures, they are not running the show.  I did a trauma rotation on a trauma team that had 1 surgeon and 2 PAs on at all times.  The PAs were capable of doing anything in the trauma bay, and would sometimes go up to surgery (usually residents first assisted).  It was interesting doing the procedures during the traumas, but most of the day was inpatient rounding.  There really wasn't much "independence" that I saw.  

And then there was the soul-wrenching following of the trauma patients for weeks.  I can deal with badness, but seeing young people, every day, who will spend the rest of their lives in assisted living being fed slushies through a feeding tube would quickly get old for me.  

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I don't ever see job advertisements for Trauma PAs. Lots of jobs for Trauma Physicians but not PAs. If one attends a residency/fellowship is it unheard of for the trauma jobs to sorta find them? How did those of you working in Trauma find your jobs?

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Ok I did finally find a few of them advertised. Mostly in Michigan, Maine, NJ, PA.........east coast. Is it too audacious to do a residency and then attempt to get up Trauma PA job on the west coast? What's the likelihood that a trauma department might create a position for you? Do you think that's something that they might be interested in? Or would a residency trained Trauma PA be limited to the positions that already exist?

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