Sexually transmitted diseases—Guide to diagnosis and therapy: ed 3. By Noble RC. New York, Medical Examination Publishing Company, 1985, 350 pages. $33.50

Abstract

While advanced cardiac life support (ACLS) and advanced trauma life support (ATLS) courses have become accepted standards for physicians who care for the critically ill and injured patient, only recently have pediatric advanced life support (PALS) courses been developed. The American Academy of Pediatrics has shown renewed interest in pediatric cardiopulmonary arrest after impressive gains made in adult resuscitation. The American Heart Association filled a void by including new chapters on Pediatric and Neonatal Resuscitation in the Textbook of Advanced Cardiac Life Support, 1981. A joint committee of AHA and AAP is seeking to unify course objectives and materials for standard curriculum. Because trauma is the most common cause of death and disability in children, pediatric trauma life support measures should be incorporated into any program directed toward emergency physicians and pediatricians who function in an emergency department or rural primary care setting. The Department of Pediatrics and Surgery and its division of Emergency Medicine has developed and implemented a PALS curriculum which is different from most other programs in that emphasis has been placed on pediatric trauma in addition to traditional cardiac (ACLS) resuscitation. This 20-hour program combines a modified ACLS curriculum with specific pediatric trauma lectures and laboratory sessions. It includes a canine surgical procedure lab and modified ATLS skill stations. At the completion of the course, students are eligible for ACLS certification. In the two years in which the course was given, 39 pediatric houseofficers were enrolled in the course. The success rate for retesting (24%) and ultimate certification (91%) of pediatric housestaff was not statistically different from rates of all other housestaff (19% and 93%, respectively). To test the attainment of trauma evaluation and management principles, a written examination and a trauma assessment testing station were developed. The goal of ACLS certification is attainable with minimal modification of the standard course. Because of the tragic results and potential salvage in pediatric trauma, an emphasis on ATLS principles of optimal care and avoidance of common pitfalls should reap improved results.