Anaesthesia trauma and critical care course

Abstract

The Anaesthesia Trauma and Critical Care Course (ATACC) was developed in 1997 to provide an alternative to the Advanced Trauma Life Support (ATLS) course (Royal College of Surgeons of Edinburgh, 2012), which would have the benefit of being developed around current clinical practice within the UK (Forrest et al, 2006). It was also highlighted that ATLS, although widely taught to various professionals, has a strong surgical bias that may not always be beneficial or appropriate. ATACC was designed to address this bias by developing a course which was representative of the need for early involvement from various specialists, especially those of anaesthesia (Forrest et al, 2006). A secondary, but equally important aim in the development of ATACC, was to provide an upto-date, evidence-based course as an alternative to ATLS, which has been critiqued for lacking appropriate underpinning evidence (Luke, 2006; Southern and Sen, 2007) and lacking relevance for UK practice (Driscoll and Wardrope, 2005; Southern and Sen, 2007). The ATACC faculty have also developed and run a number of other Rescue Trauma and Critical Care (RTACC) courses (Box 1), designed for healthcare practitioners and others working in pre-hospital environments. They also offer courses in Critical Care Patient Transfer, Incident Safety Assessment and Human Simulation Critical Incident Training (ATACC, 2011). The course itself was delivered over three days by a faculty drawn from paramedic, nurse, fire service, physician, anaesthetic and surgical specialities (Box 2). This provided an excellent opportunity to learn from specialists in their field for each aspect of the course. Instructors from the fire service for example facilitated the extrication skill station, while the instructor for the out-of-hospital trauma station was an advanced paramedic from Ireland. The three days comprise a mixture of didactic lectures, skill stations and scenarios (both indoors and out). Candidates were sent a course manual before the course commenced and were advised to read this thoroughly before the first day of the course. The course manual is a substantial work, at 262 pages long, written by a number of consultants, registrars and other practitioners. It comprehensively covers all aspects of the course and is excellent pre-reading material, providing background information on the pathophysiology of many traumatic injuries as well as easy-tofollow flowcharts for some aspects of trauma management. The manual also references numerous contemporary textbooks and articles, which makes undertaking further self directed reading an easy task. Candidates were also advised to bring their own personal protective equipment and to use this during all the practical sessions. The skill stations covered practical procedures including intubation, undertaking surgical cricothyroidotomy and thoracostomy. These sessions were excellently taught by practitioners experienced in the skill in question and used Box 1. RTACC course variations