(Reaffirmed, November 2009)
The evaluation and management of the patient who becomes a victim of trauma involving the various organ systems of the body represents a significant challenge to medicine. Since trauma to the nervous system may be particularly devastating to life and the quality of life, as well as engender serious economic losses to the individual and to society, injuries to the nervous system require particular attention. This is certain whether or not nervous system injury is the major primary injury or a part of multiple system injuries to an individual.
Neurosurgeons are trained to a high level of expertise in the management of nervous system trauma. Major advances and the understanding of the consequences of trauma to the nervous system and its management generally appear in the neuroscience literature. Many neurosurgeons spend large portions of their time in the study and management of nervous system trauma and therefore, in general, should be expected to have a higher degree of expertise in the management of nervous system trauma than others available in hospital communities.
Therefore, it seems reasonable that in the organization of the care of the injured patient that:
- The available neurosurgeon should be given the responsibility for determining the severity of nervous system injuries and for their subsequent treatment. In the patient with multiple system injuries, the neurosurgeon should develop an action and management plan with other members of the trauma team.
- The responsibility for management decisions and actions should be placed in the hands of a neurosurgeon to that degree commensurate with the severity of the nervous system trauma relative to other body system injuries.