This lecture is a roundtable discussion represented by 2 criticalists and 2 surgeons. There is a criticalist and surgeon who represent private practice and a criticalist and surgeon who represent academia. The group is mediated by a third party in debates on four or more emergency surgery topics to make sure that they stay on track on change topics after the allotted time expires. The four definitive topics are 1: Penetrating cavity puncture wounds, 2: Lower urinary tract obstruction/uroabdomen, 3: Gallbladder disease, 4: Spontaneous/traumatic hemoabdomen.
Additional topics such as foreign body gastrointestinal obstruction and open/articular/femur fractures are explored if time allows. Each participant picks one of the four topics, gives a brief overview, and then makes an argument for why or why not it warrants having a surgeon and anesthesia team come in in the middle of the night to perform emergency surgery. The goal is to focus on evidence-based medicine to support these decisions, attempt to elucidate gaps in the literature that may require further exploration and also to discuss the different hospital (private practice vs. academia) constraints that may affect why certain decisions on made given different resources available.