Zuckerberg San Francisco General Hospital and Trauma Center
Injury as the result of trauma can be one of the most challenging times for you and your family. It is our desire to help understand, assess and help in any way we can.
Anesthesiologists, specialist doctors, provide care throughout the entire journey of an injured patient.
- We are present in the Emergency Department.
- We provide anesthesia for immediately life threatening injuries, as well as any additional surgeries that may be required throughout recovery.
- Many of our Anesthesiologists work in the Intensive Care Unit where our most severely injured patients are cared for.
- We also assist in the management of pain – both as a result of the injury and any subsequent surgeries.
If you or your loved one has been a victim of violent crime, we strongly recommend you contact The Wraparound Project @ UCSF. They provide an amazing resource to help recover from this terrible life event.
If your loved one is a patient of the Intensive Care Unit (ICU) you may find it useful to read some of this information about the types of treatments that our ICU provides (link to ICU page)
Pain following some types of injury or surgery can be best managed through the placement of an Epidural (e.g. broken ribs) – if you would like to find out more about how epidurals work then please follow this link (link to epidural education page)
If you have any questions about the care of yourself or your loved one, please contact your care team or the Patient Advocate.
The UCSF Department of Anesthesia at Zuckerberg San Francisco General Hospital (ZSFG) is comprised of specialist clinicians who have a shared passion for the care of the injured patient, combined with a desire to care for the underserved members of our community by working at a premier safety net hospital.
Our Department is involved in the care of patients from all major surgical sub-specialties (excluding cardiac and transplant surgery).
The Division of Trauma Anesthesia is involved in both pre-clinical and clinical research, as well as global health initiatives. We have also developed advanced skills in tailored coagulation management, point of care testing, and massive blood transfusion.
ZSFG admits over 5000 trauma patients a year, many of whom require support and care from the Department of Anesthesia.
- Indicators for performing CT Perfusion (CTP) and CT Angiography (CTA) in traumatic brain injury at ZSFG
- Management algorithm for initial evaluation of penetrating extremity trauma
- Massive Transfusion (MT) Algorithm for Trauma Cases
- Trauma Airway Management Guidelines
- Management Algorithm for Resuscitative Thoracotomy (RT)
- Algorithm for Management of the Pregnant Trauma Patient
- Clinical Practice Manual for Trauma & Emergency Surgery
- Pelvic Binder Guideline
- Trauma Task Force Personnel and Organization
- Management Algorithm for the Initial Evaluation of Penetrating Abdominal Trauma
- LE Compartment Syndrome
- Head Trauma Algorithms for PEDI
- Management Algorithm for the Initial evaluation of Blunt Abdominal Trauma
For Providers
Care of the traumatically injured patient is complex and dynamic. It requires significant skill and flexibility in approach to maximize the likelihood of a positive outcome. Where possible these guidelines are based upon current best evidence and reviewed on a regular basis. In the absence of high quality evidence our protocols are based on decades of experience in the care of complex trauma and the unique needs of our patient population. Use of these guidelines does not substitute the need for an experienced clinician
Program Director: Vincent Lew
Trauma & Acute Care Anesthesia Fellowship
The UCSF/ZSFG Trauma & Acute Care Anesthesia Fellowship is designed to prepare junior Attending Anesthesiologists with the foundational skills and experience to become leaders in the field of Trauma Anesthesia & the preparation and management of the emergency surgical patient.
Desired Qualities
- Exceptional team member with focus on clinical leadership
- High performing communicator
- Passionate about quality improvement
- Desire to provide equitable health care
- Nuanced understanding of physiology under stress and its management
- Motivated and passionate educator
Structure
The Trauma & Acute Care Surgery Anesthesia Fellowship is a 12-month clinical, non-ACGME accredited fellowship. Fellows will be employed by UCSF as a Clinical Instructor and work an average of two to three days per week as an Attending Anesthesiologist to provide salary support. The remainder of the week will be devoted to research and educational activities. Many of these educational activities will involve clinical work in a supervised capacity.
The educational program will be divided into modules. Four core modules will be completed over the year, and a selection of elective modules will be undertaken in-line with the Fellow’s interests. The exact personalized structure of the year will be determined before the commencement of the fellowship between the Fellowship Director and the Fellow.
Core
1. Trauma Physiology, Coagulation and Management
a. A combination of self-directed learning, didactic lectures, teaching opportunities & practical skills development, including point-of-care coagulation testing
2. Perioperative Cardiac Ultrasound
a. Completion of the ECO 1 Course in Clinical Echocardiography and Ultrasound offered by www.iteachu.com in conjunction with the Society of Cardiovascular Anesthesiologists. The Fellow should be able to sit for the National Board of Echocardiography Basic PTE Certification exam by end of year.
3. Non-technical Skills in Trauma and Critical Events
a. Mentorship in the management of critical incidents. Develop a toolbox of strategies to ensure personal and team optimal performance.
b. Participate and educate in Resident Simulations with a focus on non-technical skills development
4. Professionalism & Leadership – Inside and Outside the OR
a. Exposure to anesthesia and hospital management. Experience and involvement in the LEAN management process as applied to the OR.
Electives
1. Advanced Trauma Diagnostics & Procedures
a. Coursework in Trauma Radiology (CT/XRay). Dedicated hands-on experience in the Emergency Department performing diagnostic ultrasound and FAST scans.
2. Quality Improvement
a. The Fellow will engage in a yearlong project focusing on an area of improvement for the Department of Anesthesia with a focus on emergency surgery and trauma. Examples of potential projects include – fasting times for emergency surgery; Post-Operative Analgesia in the Complex Pain Patient; Blood Transfusion management in the OR.
3. Research
a. The Fellow will join in existing clinical or translational science projects. They will have an opportunity to write or contribute to an IRB, data collection, analysis, or write up. The specific exposure will depend on current project status. Fellows will have an opportunity to participate in hypothesis generation, but are unlikely to complete a full project within the scope of their fellowship year.
4. Trauma in resource poor settings
a. The Fellow will actively engage with the Center for Global Surgical Studies @ UCSF. Depending on active projects and funding availability there may be opportunities to travel to Kampala, Uganda or the Navaho Nation to compare and contrast Trauma systems in resource poor settings.
5. Pain Management & Regional Anesthesia in Trauma
a. The Fellow will be scheduled with the regional anesthesia team with a mixture of resident supervision and self-performed blocks. They should get experience in paravertebral catheters and the role of regional anesthesia in acute traumatic pain management. In addition, they will have some exposure to the In-Patient Acute Pain Service that manages all catheter related pain issues in surgical and trauma patients.
6. Pediatric Trauma
a. This module will involve a clinical rotation to Children’s Hospital Oakland (CHO). The Fellow will undertake one day per week for 6-8 weeks. The Fellow will participate in elective and emergency pediatric anesthesia gaining additional exposure to vascular access, transfusion and pediatric trauma. This opportunity is conditional on the Fellow being able to successful acquire credentials at CHO.
The Division of Trauma Anesthesia is actively involved in research to improve the care of the injured patient. We participate in both clinical and non-clinical research, with many of our faculty running laboratories in basic sciences research.
The Trauma Anesthesiology Society (TAS) is an international society of clinicans who are advancing the care of the critically injured through the application of the art and science of trauma anesthesia.
Many of our senior staff have been instrumental in the success of the organization and continue to be involved today. We highly recommend those who are interested in the care of the trauma patient consider joining the Society and interacting with the leaders in their fields.
The TAS Website contains educational content, latest news, and links to meetings & events. Visit them here.
ZSFG Anesthesia Preoperative Clinic
If you are scheduled for surgery, you will have a clinic visit scheduled to address questions about anesthesia and pain control. The goal at the Anesthesia Preoperative Clinic is to provide patients all the information you need to set your mind at ease about the safety of anesthesia and relief of post-surgical pain.
When you visit us, we will obtain a detailed medical history and physical exam as well as review your past and current test results and medications. You will be informed of the anesthesia care plan personalized to your unique health needs. We will coordinate indicated tests or consultations if needed prior to your surgery. We provide written instructions for preparing for surgery and onsite phlebotomy services.
Our clinic team consists of dedicated nurse practitioners, anesthesiologists, nurses and medical assistants.
Location:
1001 Potrero Avenue, 4M
San Francisco, CA 94110
Phone: (415) 206-5693
Fax: (415) 206-5811
Hours of Operation:
Monday through Friday, 8am-12pm and 1pm-5pm.
We close in observation of DPH Holidays