Abstract
Introduction：The scope of Acute Care Surgery （ACS） is recognized as five pillars, but there are other roles that ACS should play.
Our Attempts：We have carried out the following activities as a regional surgical crisis management department. （1） IMAT agreement with Chiba Prefectural Police special forces, （2） Deployment of a trauma surgery team jointly with the Self-Defense Forces near the summit venue, （3） Formulation of a plan for mass casualty incidents common to our medical control area, and repeated multi-institutional training.
Discussion：Today, as surgery has become more specialized, ACS is the most appropriate surgical crisis management department to deal with surgical risks inside and outside the hospital. In order to develop and manage surgical crisis management system, it is necessary to have a mature ACS team with high level trauma surgery skills especially penetrating trauma, and its director might be familiar with disaster medicine and medical control. This division may collaborate with fire departments, government, police, and the Self-Defense Forces. In order to train such doctors and teams in the future, it is necessary to clarify the role of the surgical crisis management department, position it as an advanced ACS function, and create an environment where they can be exposed to the necessary experience.
