Clinical Practice

As the region’s lead Level 1 trauma center, adult trauma activations at University Hospital average over 4,500 per year with an average case mix of 10% penetrating trauma, 85% blunt trauma, and 5% burns. As the region’s only pediatric trauma/burn center, University Hospital receives over 1,100 pediatric trauma activations per year, providing pediatric trauma and burn management exposure. 

The Trauma Resuscitation Unit (TRU) in the Sky Tower at University Hospital consists of a 20-bed integrated acute and subacute trauma area, consisting of six open bay trauma/critical care beds, ten subacute trauma beds, and four pediatric trauma resuscitation beds. Two modern 256-detector CT scanners support the trauma and emergency surgery service, and overhead monitors in each trauma bay display vital signs and videos during intubations or ultrasound procedures. When on-call, fellows direct care in the TRU as well as lead the resuscitation and operative management of trauma and emergency surgery patients.

In addition to trauma and surgical critical care, the division also runs the emergency surgery service at University Hospital, which manages about 1,500 patients per year. With a variety of complex general surgical problems, fellows gain significant operative and critical care experience managing common general surgical issues, surgical infections, and complications of the surgical disease. 

The $778 million 716-bed Sky Tower at University Hospital, opened in 2013, has 35 operating rooms, two of which are dedicated to the Trauma and Emergency Surgery service. The hybrid trauma/interventional radiology operating suite is reserved for critically-ill trauma patients and those requiring emergency trauma surgery. The acute care surgery suite functions 24/7/365 to manage our multiple emergency and general surgery cases.

When on-call during rotations at University Hospital, fellows are provided the opportunity to manage trauma patients in the trauma bay, perform required surgical procedures or operations, and direct the critical care aspects of post-operative care, all in coordination with one of the two in-house trauma/surgical critical care faculty. Similarly, emergency surgery patients are managed by fellows on call, from initial evaluation to operative intervention and postoperative care.

Surgical Critical Care

A modern 30-bed Surgical Trauma ICU at University Hospital provides care for general, trauma, emergency surgery, ENT, plastics, orthopedics, vascular, and ob/gyn patients. All critically ill patients are managed by the Surgical Critical Care service in conjunction with the primary team. In addition to surgical residents, three advanced practice faculty clinicians are permanently assigned to the ICU.

Fellows are responsible for the leadership and management of the three ICU teams in conjunction with surgical critical care faculty. Multidisciplinary bedside teaching rounds are conducted on a daily basis, focusing on all aspects of the critically ill patient.

Advanced Training Opportunities

In addition to daily teaching rounds, weekly conferences, and additional didactics, the UT Health San Antonio SCC fellowship offers the following training opportunities:

  • Advanced Trauma Life Support (ATLS)
  • Advanced Surgical Skills for Exposure in Trauma (ASSET)
  • Clinical Safety and Effectiveness Course (CS&E)
  • NIH Research Course – Introduction to the Principles and Practice of Clinical Research (IPPCR)
  • Critical Care Ultrasound/ECHO
  • IVC Filter Placement