Acute Care Surgery

About Us

Acute Care Surgery is a developing field of surgery that has taken the principals of trauma care (organized teams, evidence-based processes and procedures, and continuous quality improvement) and applied them to patients with other urgent, time-sensitive surgical conditions. Thus, our Acute Care Surgery team provides the full range of care to patients who are critically ill with acute surgical emergencies, shock, severe sepsis, respiratory failure, and advanced multi-organ failure, in addition to caring for patients with traumatic injuries.

Stanford Health Care's Trauma program provides the full range of patient care services for both adult and pediatric trauma patients. Stanford's Trauma Center was established in 1986 and is designated by Santa Clara County EMS and verified by American College of Surgeons as a Level I trauma center. It serves both Stanford Hospital and Lucile Packard Children's Hospital.

The program serves primarily northern Santa Clara and southern San Mateo counties and also collaborates with surrounding counties to coordinate trauma patient care and provide referral resources for their patients who require highly specialized care.

Injury is the major under-appreciated health problem in United States. It is the major cause of death between ages 1 and 44. The number of trauma-related deaths annually approaches 150,000. On a daily basis, this is the equivalent of a fully-loaded 747 plane crashing with no survivors. The resulting loss of productive years of life exceeds that of cancer and cardiovascular disease combined, with associated societal costs exceeding $500 billion annually. In fact, injury will equal or surpass communicable disease in the year 2020 as the number one cause of disability-adjusted-life-years world-wide.

Program Priorities

The vision of the Trauma Program at Stanford University Medical Center and Lucille Packard Children's Hospital is to achieve national prominence through leadership and innovative contribution to the care of injured and critically ill patients.

The Missions of the Trauma Program are to:

1. provide the highest quality of care for all injured and critically ill children and adults of the Peninsula and Greater Bay Area
2. provide comprehensive and effective violence and injury prevention programs for both children and adults
3. advance knowledge and improve patient care through injury and critical illness research
4. develop a trauma outcomes research program that focuses on the psychological effect of trauma on patients and their families and initiate treatment to minimize the long-term consequences.

Our goal is to develop a patient-centered program that will address the needs of each patient but which will also enable us to address these larger issues and improve the results for all trauma patients.

Surgeons in this section see patients for trauma follow-up and general surgery care at the Stanford Healthcare Pavilion A in the main hospital. This website will provide access to contact information: Trauma Service

Trauma Surgeons

David L. Gregg, MD Professor in General Surgery


Dr. David A. Spain is the David L. Gregg, MD Professor and Chief of Acute Care Surgery. His clinical areas of specialty are emergency and elective general surgery, trauma and critical care. His research focus is assessment of clinical care, systems of care and assessment of stress response and PTSD after trauma. He is the current President of the American Association for the Surgery of Trauma. He is a Councilor of the American Board of Surgery and Director of the Surgical Critical Care board. He is the editor of the textbook Scientific American's Critical Care of the Surgical Patient. Dr. Spain is also the General Surgery Residency Program Director at Stanford.
Clinical Assistant Professor, Surgery - General Surgery
Clinical Instructor, Surgery - General Surgery


My research focuses on the care of the injured patient, surgical infectious disease, and global public health. I want to change how humans interact with the microbial world. After receiving my BA in Biochemistry from The Colorado College I went to the University of Virginia for medical school. During these years, I fell in love with surgery, but maintained my fascination with microbes. To explore this interest in the microbial world I obtained a Masters of Science in Infectious Disease from the London School of Hygiene and Tropical Medicine. Then I came to Stanford for general surgery residency. During my two professional development years in surgery residency I applied for and was accepted into the Epidemic Intelligence Service (EIS), the premier training program for infectious disease field epidemiology. My domestic investigations concerned pathogens including Lyme disease and tick-borne relapsing fever, in addition to two Tier 1 bioterrorism agents plague and tularemia. Internationally, I was a field agent in Liberia during the 2014 Ebola outbreak and performed several high-visibility, high-risk investigations. These investigations included establishing how the first two Americans, Kent Brantley and Nancy Writebol became infected, and assessing the Ebola burden and Ebola preparedness in southeast Liberia, among others. Following my experience with EIS, I completed my general surgery residency training at Stanford, followed by completion of surgical critical care fellowship training at Stanford. Ongoing projects currently include: -Determining who benefits from surgical stabilization of rib fractures and how we can stabilize rib fractures most effectively -Understanding the limitations of surgical infectious disease surveillance and improving capacity for surgical infection surveillance globally -Using to technology to increase the speed by which we can identify and track surgical pathogens Follow me on Twitter @explorersurgeon and on Instagram @joe_d_forrester
Assistant Professor of Surgery (General Surgery) at the Stanford University Medical Center


Dr. Knowlton is a trauma and critical care surgeon and public health researcher whose focus is on improving access to and quality of care for trauma and surgical patients. She obtained her medical degree at McGill University and completed her general surgery residency at the University of British Columbia in Vancouver, Canada. Her desire to understand varied healthcare systems and develop solutions for vulnerable surgical populations led her to obtain an M.P.H. at the Harvard T.H. Chan School of Public Health and complete a research fellowship at the Harvard Humanitarian Initiative. Most recently, she trained as a Surgical Critical Care fellow at Stanford University Medical Center and joined the faculty as an Assistant Professor of Surgery in early 2018. Dr. Knowlton's research focuses on addressing barriers in access to care and reducing disparities among vulnerable surgical populations, including underinsured trauma patients. She is also investigating the financial burden that injury imposes upon both patients and hospitals, with the goal of finding economically sustainable strategies for ensuring best outcomes among trauma patients. These include the study of emergency Medicaid programs at the state and national level. She was recently awarded the 17th C. James Carrico Faculty Research Fellowship by the American College of Surgeons to better understand the link between socioeconomic status, insurance coverage and quality of patient outcomes for trauma patients receiving care within U.S hospitals. Dr. Knowlton is board certified by the American Board of Surgery and the Royal College of Physicians and Surgeons of Canada. In addition to her research work surrounding surgical disparities, she is a member of the American Association for the Surgery of Trauma Diversity and Inclusion Committee, as well as the Stanford Surgery Diversity and Inclusion Cabinet.
Associate Professor of Surgery (General Surgery) at the Stanford University Medical Center


Dr. Paul Maggio is Vice Chair of Surgery for Clinical Affairs, Associate Chief Medical Officer of Operational Effectiveness, and Associate Director of the Adult Intensive Care Unit. He trained in General Surgery at Brown University and obtained advanced training in Adult Surgical Critical Care and Trauma at the University of Michigan. He holds a Masters of Business Administration from the University of Michigan and is triple board certified in General Surgery, Critical Care, and Medical Informatics. In addition to being a clinician and surgeon, Dr. Maggio participates in the National Committee on Healthcare Engineering for the American College of Surgeons, and his research interests are focused on the delivery of high-value care. Dr. Maggio received the SHC Board of Hospital Director’s Denise O’Leary Award for Clinical Excellence in 2013
Clinical Assistant Professor, Surgery - General Surgery


Dr. Nassar is a board certified General Surgeon in both the USA and Canada. Dr. Nassar has five years of clinical experience in tertiary care referral academic health-centres in Canada prior to joining Stanford University in surgery, trauma and critical care. His clinical interests are emergency and elective surgery in addition to trauma and critical care medicine. He is also a skilled endoscopist performing both upper and lower gastrointestinal endoscopy. His research interests are varied and include the development of assessment tools for trainees, burnout among physicians and other healthcare professionals. In addition he is especially interested in training trainees in simulation based medical education with a focus on perioperative inter-professional collaboration and patient safety. He is a true clinician educator and is a certified simulation educator as well as an ATLS course director. Dr. Nassar has also earned an MSc degree in Health Science Education from McMaster University, Canada.
Professor of Surgery (General Surgery)


Carla Pugh is Professor of Surgery at Stanford University School of Medicine. She is also the Director of the Technology Enabled Clinical Improvement (T.E.C.I.) Center. Her clinical area of expertise is Acute Care Surgery. Dr. Pugh obtained her undergraduate degree at U.C. Berkeley in Neurobiology and her medical degree at Howard University School of Medicine. Upon completion of her surgical training at Howard University Hospital, she went to Stanford University and obtained a PhD in Education. She is the first surgeon in the United States to obtain a PhD in Education. Her goal is to use technology to change the face of medical and surgical education. Her research involves the use of simulation and advanced engineering technologies to develop new approaches for assessing and defining competency in clinical procedural skills. Dr. Pugh holds three patents on the use of sensor and data acquisition technology to measure and characterize hands-on clinical skills. Currently, over two hundred medical and nursing schools are using one of her sensor enabled training tools for their students and trainees. Her work has received numerous awards from medical and engineering organizations. In 2011 Dr. Pugh received the Presidential Early Career Award for Scientists and Engineers from President Barak Obama at the White House. She is considered to be a lead, international expert on the use of sensors and motion tracking technology for performance measurement. In 2014 she was invited to give a TEDMED talk on the potential uses of technology to transform how we measure clinical skills in medicine. In April 2018, Dr. Pugh was inducted into the American Institute for Medical and Biological Engineering.
Associate Professor of Surgery (General Surgery) at the Stanford University Medical Center


Dr. Kristan Staudenmayer received her medical degree at the University of Texas at Southwestern Medical School in 1999, and completed her residency in General Surgery at Parkland Hospital in 2006. During her post-graduate training, she conducted NIH T32-funded research at Harborview Hospital evaluating the effects of innate immunity on trauma. She obtained further training in Trauma and Surgical Critical at San Francisco General Hospital, completing her training in 2008. She was subsequently double-boarded in General Surgery and Surgical Critical Care. Dr. Staudenmayer joined Stanford in 2008. She has developed a robust research program and active clinical practice. Her clinical and research interests have contributed to Stanford’s multi-disciplinary approach to the management of surgical trauma. Dr. Staudenmayer’s clinical focus is on trauma, emergency general surgery, and surgical critical care, and her research interests encompass trauma systems of care and vulnerable patient populations such as the elderly. Her efforts have been noteworthy and recognized in her 2013 K08 grant from the National Institute on Aging to study trauma in the elderly population. In 2016, Dr. Staudenmayer was honored by becoming the inaugural Gordon and Betty Moore Endowed Faculty Scholar, which helps to support her ongoing research efforts. Additional research accomplishments include being a co-principal investigator on an NIH CTSA award evaluating trauma systems. Dr. Staudenmayer has published over 50 articles and book chapters and has served on the editorial review board of several academic journals. She contributes nationally towards the academic mission by serving on committees for both the American Association for the Surgery of Trauma and the Eastern Association for the Surgery of Trauma. Dr. Staudenmayer was promoted to Associate Professor of Surgery in 2016, and continues her research, policy and advocacy work to improve the care and outcomes for patients with traumatic injuries and critical surgical illnesses.
Associate Professor of Surgery (General Surgery) at the Stanford University Medical Center


I am a general and trauma surgeon, and surgical intensivist. I treat and care for injured patients and those with acute surgical emergencies, and manage critically ill surgical patients in the Intensive Care Unit. My research is focused on evaluating the role of surgical care in the delivery of health services in resource poor settings, particularly low and middle income countries. I am interested in barriers to access and provision of surgical care, the quality of surgical services, and outcomes research. My current projects focus on quality and cost effectiveness of care, and strategies for improving the safety and reliability of surgical delivery in resource poor settings. I have been involved in surgical program assessment projects in Cambodia, India, the UK, and the United States. From 2006-2009 I was part of the World Health Organization’s Safe Surgery Saves Lives program where we quantified the global volume of surgery and created, implemented, evaluated, and promoted the WHO Surgical Safety Checklist. I am the Consulting Medical Officer for Lifebox, a charity devoted to saving lives through safer surgery. We are currently engaged in multiple programs to improve anesthetic safety, reduce surgical infection, improve teamwork, and strengthen compliance with surgical safety standards in low resource settings.

Stanford SWAT

Stanford SWAT (Surgeons Writing About Trauma) is the trauma and acute care surgery research group at Stanford Health Care. For more information, click here or contact

Stanford hospitals reverified as Level I trauma center

The American College of Surgeons has reverified Stanford Health Care and Lucile Packard Children’s Hospital Stanford as an adult and pediatric Level I trauma center, the highest possible ranking for trauma centers.