Advanced Trauma Life Support Course Research Articles

Optimizing Advanced Trauma Life Support (ATLS®) to Maximize Readiness.

The Army utilizes Individual Critical Task Lists (ICTLs) to track and ensure competency and deployment readiness of its medical service members. ICTLs are the various skills and procedures that the Army has deemed foundational for each area of concentration (AOC)/military occupational specialty (MOS). While many ICTLs involve the patient care that military medical providers regularly provide, some procedures are not as commonly performed. This, when coupled with lower patient volume at military treatment facilities (MTF), poses a challenge for maintaining skill competency and deployment readiness. Fort Campbell's Blanchfield Army Community Hospital (BACH) has created a holistic and unique solution to meet many of these standardized requirements and support a ready medical force. By optimizing the Advanced Trauma Life Support (ATLS®) course curriculum to facilitate ICTL completion, BACH has increased its ICTL completion rates, ATLS® course exposure, and streamlined training requirements. The purpose of this article is to describe this best practice and suggest its applicability to other MTFs. By cross-referencing the ATLS® course curriculum and appendices with ICTLs, BACH has augmented ATLS® course certification with the additional completion of 12 ICTLs. This new approach not only increases ICTL completion, but also increases ATLS® curriculum exposure to medical providers, such as Registered Nurses or Nurse Practitioners, who would not typically take ATLS®. Since starting this new approach in April 2021, 73 military medical personnel have completed the ATLS® course at BACH, with 24 different medical specialties represented. A total of 361 ICTLs have been completed with specific ICTL completion counts ranging from 13 to 48. Each ICTL tested was completed 100% of its annual requirement. ATLS® is a mandatory joint interoperability standard for military physicians and it is also an Army ICTL for many AOCs/MOSs. Only counting completion of this course as one ICTL is a missed opportunity for the time spent by Army medical providers and limits the exposure of ATLS® to select AOCs/MOSs. This optimized and novel approach has been successful at BACH, suggesting its applicability at other MTFs that serve as ATLS® testing sites.

Effect of trauma quality improvement initiatives on outcomes and costs at community hospitals: A scoping review

BackgroundDue to complex geography and resource constraints, trauma patients are often initially transported to community or rural facilities rather than a larger Level I or II trauma center. The objective of this scoping review was to synthesize evidence on interventions that improved the quality of trauma care and/or reduced healthcare costs at non-Level I or II facilities. MethodsA scoping review was performed to identify studies implementing a Quality Improvement (QI) initiative at a non-major trauma center (i.e., non-Level I or II trauma center [or equivalent]). We searched 3 electronic databases (MEDLINE, Embase, CINAHL) and the grey literature (relevant networks, organizations/associations). Methodological quality was evaluated using NIH and JBI study quality assessment tools. Studies were included if they evaluated the effect of implementing a trauma care QI initiative on one or more of the following: 1) trauma outcomes (mortality, morbidity); 2) system outcomes (e.g., length of stay [LOS], transfer times, provider factors); 3) provider knowledge or perception; or 4) healthcare costs. Pediatric trauma, pre-hospital and tele-trauma specific studies were excluded. ResultsOf 1046 data sources screened, 36 were included for full review (29 journal articles, 7 abstracts/posters without full text). Educational initiatives including the Rural Trauma Team Development Course and the Advanced Trauma Life Support course were the most common QI interventions investigated. Study outcomes included process metrics such as transfer time to tertiary care and hospital LOS, along with measures of provider perception and knowledge. Improvement in mortality was reported in a single study evaluating the impact of establishing a dedicated trauma service at a community hospital. ConclusionsOur review captured a broad spectrum of trauma QI projects implemented at non-major trauma centers. Educational interventions did result in process outcome improvements and high rates of self-reported improvements in trauma care. Given the heterogeneous capabilities of community and rural hospitals, there is no panacea for trauma QI at these facilities. Future research should focus on patient outcomes like mortality and morbidity, and locally relevant initiatives.

Healthcare Professional's Knowledge of the Systemic ABCDE Approach: A Cross-Sectional Study.

Background and aim Assessing the knowledge of healthcare professionals regarding the Airway, Breathing, Circulation, Disability, and Exposure (ABCDE) approach is crucial since it prioritizes the initial assessment and treatment of patients who are critically ill, regardless of the underlying cause or their age. Since adherence requires knowledge, this study aimed to evaluate the knowledge level of the ABCDE approach among healthcare professionals. Methods This cross-sectional study among healthcare professionals was performed from April to August 2023 in Taif City, Saudi Arabia. The study included healthcare professionals employed in departments exposed to patients with critical illnesses and excluded those from other specialties and individuals from outside Taif City. Data was collected via Google Forms using a previously validated questionnaire designed to assess the ABCDE approach knowledge among healthcare professionals. Statistical analysis was conducted using IBM SPSS, version 26. Results The study included 242 healthcare professionals with a mean (SD) age of 35.77 (9.93) years. About half of the participants were female (52.5%) nurses (50.8%) and had been working in intensive care units (ICU) and neonate intensive care units (NICU) (41.4%). The mean (SD) of the participants' working experience was 9.28 (8.295) years. The overall mean test score was 52.94 % (SD 16.27). The mean knowledge score among males was significantly higher than females (56.37% vs. 49.85%, respectively) (p-value= 0.001). The mean knowledge score was significantly higher among medical specialists and residents (63.308% and 55.67%) than among nurses (46.34%) (p-value <0.001). Attending an advanced trauma life support course and theoretical lecture significantly impacted the total knowledge score among the participants (p-values= 0.001 and <0.001, respectively). The total knowledge significantly increased with age (r: 0.265, p-value <0.001). Years of experience correlated with total knowledge score; with increasing years of experience, the total knowledge was significantly increased (r: 0.248, p-value <0.001). Conclusion The ABCDE approach is a valuable tool for the initial examination and treatment of patients in acute medical and surgical emergencies. The findings indicate that there is a need for further awareness programs and training on the ABCDE approach, as the total knowledge score among healthcare professionals was found to be suboptimal. Further research is needed to assess the association between knowledge level and clinical performance in different healthcare settings within Saudi Arabia.

The ATLS® Course: Empowering Healthcare Professionals for Excellence in Trauma Care.

The Advanced Trauma Life Support (ATLS) course has become an indispensable tool in preparing health care professionals to provide optimal trauma care.&#x0D; This article highlights the impact of the ATLS course on empowering healthcare professionals for excellence in trauma care.&#x0D; By providing a standardized framework, enhancing critical decision-making skills, and promoting interdisciplinary collaboration, the ATLS course equips practitioners with the knowledge and skills necessary to effectively respond to trauma emergencies. Additionally, the course prepares healthcare professionals for the unpredictable nature of trauma care through simulation-based training and fosters a culture of continuous professional growth.&#x0D; Through its emphasis on standardization, critical thinking, and continuing education, the ATLS course plays a vital role in improving patient outcomes and establishing a foundation for excellence in trauma care.&#x0D; Conclusion: The ATLS course stands as a testament to the commitment of healthcare professionals to provide excellent trauma care. It empowers practitioners with the necessary knowledge, skills, and standardized approach to save lives in the critical moments following traumatic events.

Disparities in trauma care education: An observational study of the ATLS course within a national trauma system

BackgroundDisparities in trauma systems, including gaps between trauma center levels, affect patient outcomes. Advanced Trauma Life Support (ATLS) is a standard method of care that improves the performance of lower-level trauma systems. We sought to study potential gaps in ATLS education within a national trauma system. MethodsThis prospective observational study examined the characteristics of 588 surgical board residents and fellows taking the ATLS course. The course is required for board certification in adult trauma specialties (general surgery, emergency medicine, and anesthesiology), pediatric trauma specialties (pediatric emergency medicine and pediatric surgery), and trauma consulting specialties (all other surgical board specialties). We compared the differences in course accessibility and success rates within a national trauma system which includes seven level 1 trauma centers (L1TC) and twenty-three non-level 1 hospitals (NL1H). ResultsResident and fellow students were 53% male, 46% employed in L1TC, and 86% were in the final stages of their specialty program. Only 32% were enrolled in adult trauma specialty programs. Students from L1TC had a 10% higher ATLS course pass rate than NL1H (p = 0.003). Trauma center level was associated with higher odds to pass the ATLS course, even after adjustment to other variables (OR = 1.925 [95% CI = 1.151 to 3.219]). Compared to NL1H, the course was two-three times more accessible to students from L1TC and 9% more accessible to adult trauma specialty programs (p = 0.035). The course was more accessible to students at early levels of training in NL1H (p < 0.001). Female students and trauma consulting specialties enrolled in L1TC programs were more likely to pass the course (OR = 2.557 [95% CI = 1.242 to 5.264] and 2.578 [95% CI = 1.385 to 4.800], respectively). ConclusionsPassing the ATLS course is affected by trauma center level, independent of other student factors. Educational disparities between L1TC and NL1H include ATLS course access for core trauma residency programs at early training stages. Some gaps are more pronounced among consulting trauma specialties and female surgeons. Educational resources should be planned to favor lower-level trauma centers, specialties dealing in trauma care, and residents early in their postgraduate training.

Proceedings from the Second Medical Summit on Firearm Injury Prevention, 2022: Creating a Sustainable Healthcare Coalition to Advance a Multidisciplinary Public Health Approach.

Proceedings from the Second Medical Summit on Firearm Injury Prevention, 2022: Creating a Sustainable Healthcare Coalition to Advance a Multidisciplinary Public Health Approach.

Advanced trauma life support course for medical students. A new era?

Trauma represents a major public health issue and is one of the leading causes of death and disability worldwide. A systematic approach toward dealing with trauma patients was facilitated through the ATLS program, which has become a milestone in trauma care. Our new ATLS course for medical students was set in motion in 2015. Our aim was to make medical students familiar with trauma patients interactively, through a program like ATLS, and here we present the results of this endeavor. A two-day ATLS-Medical Student (MS) course was offered from November 2015 to July 2018, and analysis was performed retrospectively on the data gathered over a three-month period through online questionnaires. Before graduating, 261 newly qualified medical doctors were interviewed and evaluated as part of the ATLS course. After the course, the vast majority of medical students (251 MSs; 96.16%) felt more capable of managing severely injured patients and 58% of students felt that the medical services they offered were better due to the ATLS training. Regarding the educational fee for the course, 56.7% of the students reported that they felt the fee of 100 euros was fair. The interactive format of the course, which differs from more traditional methods of teaching, has been endorsed by medical students. Though they lack clinical experience, that does not prohibit them from acquiring more specialized or specific knowledge, enabling them to excel. Most of the students improved their skillset either in theoretical knowledge, practical skills, or even in the emotional component of the course, i.e., dealing with treating a severely injured patient. It was decided that the program would be re-evaluated and extended to all Greek Medical Schools. The advantage of providing doctors with trauma training at the beginning of their careers is evident. For that reason, it was decided that the program would be re-evaluated and extended to all Greek Medical Schools.

An Educational Outreach Program: A Trauma System's 5-Year Experience.

The American College of Surgeons Committee on Trauma requires Level I and II trauma centers to provide educational outreach to lower-level facilities. Although outreach is a required part of any trauma system, very little is published on the resources required for a successful program. The purpose of this article is to provide a comprehensive roadmap of the required components to achieve a successful trauma outreach program. This project describes the development and implementation of an educational outreach program from January 2016 to December 2020 that has grown from 27 facilities within one western state to 49 facilities across 14 different states. Program components measured include the number and attendance of trauma courses offered, including the Trauma Nursing Core Course (TNCC), Advanced Trauma Life Support (ATLS), Rural Trauma Team Development Course (RTTDC), the number of trauma meetings and webinars provided, total trauma center designation and reviews, total states reached, and total trauma center collaborations. From 2016 to 2020, the program more than doubled the number of TNCC and ATLS courses, maintained the number of RTTDC offered, and observed attendance rate increases of 33% and 11% for TNCC and ATLS courses, respectively. Outreach leadership attended 44 trauma meetings and educational webinars using virtual platform technology, nearly doubling the trauma center outreach with expansion across 14 states resulting in important changes in practice. With administrative support, effective leadership, and technology, outreach programs can serve as important resources for statewide trauma systems.

Barriers Facing Primary Health Care Physicians in Jazan when Dealing with Emergency Cases

Background: Primary healthcare centres (PHCCs) provide curative and preventative healthcare services. Little is known about perceived competence in handling potential emergencies by family physicians at PHCCs. Aim of Study: To identify primary healthcare (PHC) physicians’ emergency management competence and the barriers they experience when dealing with emergency cases. Method: A descriptive questionnaire-based cross-sectional study of family physicians in Jazan Governorate, in south west of Saudi Arabia. We used Poisson regression modelling to evaluate the effect of background factors on perceived competence in handling emergency cases among family physicians. Results: The study included 450 PHC physicians; 342 (77.8%) were males, and 364 (82.7%) were Saudi. When compared to Arab Board of Family Medicine (ABFM) certification, physicians did better if they had Family Medicine (FM) Diploma (OR = 1.1486, p = 0.03704) or MBBS (OR = 1.1529, p = 0.00371). Compared to physicians who attended Basic Life Support (BLS) courses within the last 12 months, competence in clinical emergencies was far worse for those who did not do BLS (OR = 0.6710, p &lt;0.001), or did it over two years ago (OR = 0.8796, p&lt;0.001). Notably, there was no difference between those who did BLS last year or within two years’ time frame. Attending the Advanced Trauma Life Support (ATLS) course was associated with better emergency knowledge and competence if completed withinone year than within two years (OR = 0.9071, p = 0.002), over two years (OR = 0.8694, p&lt;0.001), or not done at all (OR = 0.9527, p = 0.01452). Advanced Cardiovascular Life Support (ACLS) course attendance was not associated with significant gains in terms of competence. Experience in Emergency Departments (ED) was associated with worse self-rating of competence in emergency cases (OR = 0.9527, p = 0.01452). Conclusions: BLS and ATLS courses improve perceived competence among PHC physicians. There is a potential gap in defibrillation training among PHC-based family physicians in the southwestern area of Saudi Arabia. Therefore, BLS training should be an integral part of family physician core competence in handling emergency cases. More educational training should be devoted to defibrillation skills in clinical practice. Key words: Primary Healthcare, Family physician, Emergency care, competence, barriers, Saudi Arabia.

Global Survey of Demand-Side Factors and Incentives that Influence Advanced Trauma Life Support (ATLS) Promulgation.

We aimed to identify and describe demand-side factors that have been used to support ATLS global promulgation, as well as current gaps in demand-side incentives. We performed a cross-sectional survey about demand-side factors that influence the uptake and promulgation of ATLS and other trauma-related CME courses. The survey was sent to each of the four global ATLS region chiefs and 80 ATLS country directors. Responses were described and qualitative data were analyzed using a content analysis framework. Representatives from 30 countries and each region chief responded to the survey (40% response rate). Twenty of 30 country directors (66%) reported that there were some form of ATLS verification requirements. ATLS completion, not current verification, was often the benchmark. Individual healthcare systems were the most common agency to require ATLS verification (37% of countries) followed by medical/surgical accreditation boards (33%), governments (23%), training programs (27%), and professional societies (17%). Multiple credentialing frameworks were reported including making ATLS verification a requirement for: emergency unit or trauma center designation (40%), contract renewal or promotion (37%); professional licensing (37%); training program graduation (37%); and increases in remuneration (3%). Unique demand-side incentives were reported including expansion of ATLS to non-physician cadre credentialing and use of subsidies. ATLS region chiefs and country directors reported a variety of demand-side incentives that may facilitate the promulgation of ATLS. Actionable steps include: (i) shift incentivization from ATLS course completion to maintenance of verification; (ii) develop an incentive toolkit of best practices to support implementation; and (iii) engage leadership stakeholders to use demand-side incentives to improve the training and capabilities of the providers they oversee to care for the injured.

Succeeding in Continuing Trauma Education During a Pandemic.

BackgroundCorona virus disease 2019 (Covid-19) impacted continuing medical education programs such as the Advanced Trauma Life Support (ATLS) course. Modifications made to medical training like teleconferencing could affect students’ learning success. We sought to evaluate the effects of the American College of Surgeons modifications on success rates in passing the ATLS course.MethodsThis study evaluated 28 ATLS 10th edition courses educating 898 students at our region before and after Covid-19 modifications. Traditional two-day courses were performed in-person while modified courses were conducted with a one-day teleconference followed by a second in-person practical day. We compared the characteristics and course pass rates between the traditional and modified ATLS courses.ResultsModified ATLS courses had significantly lower pass rates (81.0%; 95% confidence interval = [74.8–87.3]) compared to traditional ATLS courses (94.3%; [92.2–96.3]).ConclusionsModifications to the ATLS course are associated with lower student pass. This is possibly due to ineffective knowledge consolidation. Better modifications to the course are required such as use of electronic learning tools with modification to course schedule or returning to the traditional course but with the use of Covid-19 vaccines and other protective measures. These suggestions should be considered and evaluated further by ATLS program leaders.

Trauma training in low- and middle-income countries: A scoping review of ATLS alternatives.

IntroductionTrauma training for front-line providers is a critical component of injury mitigation and trauma systems strengthening. Although the Advanced Trauma Life Support (ATLS) course is standard in much of the world, cost and administrative barriers are prohibitive to deploying the course in many low and middle income countries (LMICs). The purpose of this study was to identify alternative trauma training courses used in LMICs by scoping review and compare their effectiveness.MethodsSeveral peer-reviewed and grey literature databases were searched for relevant articles describing trauma training courses for front-line medical providers in LMICs. Studies were included if: performed in a LMIC; utilized a general trauma training course other than ATLS; trainees were hospital-based medical providers; study included some type of outcome measure.ResultsA total of 34 manuscripts met inclusion criteria. The majority of courses were novel, hospital-initiated courses and ranged in length from 1 day to 1 week. Physicians were the most common target audience, followed by medical students and nurses. Courses were taught in 24 different countries throughout the Middle East, Asia, Latin America and Africa. Comparison of pre- and post-test knowledge was the most common metric used and nearly all courses demonstrated a statistically significant knowledge gain. One study demonstrated a reduction in mortality for injured patients after course implementation. The majority of courses were a collaboration between universities in a high income country and local faculty/practitioners in the LMIC where the course was taught. Reported cost per participant ranged from $10 to $232 USD.ConclusionsSeveral trauma courses are currently being utilized in LMICs effectively with increases in knowledge gained and at a lower reported cost than ATLS. More research is needed to link trauma training courses to patient outcomes.

Barriers facing family physician in primary health care when dealing with emergency cases in Riyadh, Saudi Arabia.

The scarcity of emergency cases presented to the primary health care centers (PHCCs) makes treating such cases by family physicians more difficult To identify the barriers facing family physicians in PHCCs when facing emergency cases in Riyadh, Saudi Arabia. A cross-sectional descriptive design was deployed in the study among a sample of family physicians. A reliable and valid self-reported questionnaire was used. In addition, an observational sheet was used to investigate the preparedness of PHCCs to deal with emergency situations. The study included 162 PHC physicians. Almost two-thirds of them (65.4%) aged 25-34 years, and 52.5% were females. Middle-aged (25--35 years) physicians (P = 0.030), females (P < 0.001), Saudis (P = 0.027), those attended advanced cardiovascular life support (ACLS) since more than 2 years (P = 0.029), those who had no exposure in working in emergency units (P = 0.029), and less experienced physicians (<1 year) (P = 0.010) showed lower "perceived level of competence in performing emergency skills." The commonest barrier facing physicians during the management of emergency cases in thePHC was lack of appropriate equipment (76.5%), followed by lack of exposure to emergency cases (62.3%) and lack of time (50.6%). Dealing with emergency cases is considered part of the medical practice in PHCCs. For primary care physicians, the level of training in emergency medicine courses is suboptimal particularly advanced trauma life support (ATLS) courses in Riyadh. Inregards to emergency services at the PHC level in Riyadh, most of the items were available; however, defects were reported in some. Knowing the barriers facing doctors during dealing with emergency cases helps in improving and providing integrated medical care.

Mixed methods approach to understanding the influence of changes in successive versions of the advanced trauma life support training program on student performance

BackgroundThe Advanced Trauma Life Support course is the American College of Surgeons’ standard of care for physicians who provide initial care to trauma victims. In addition to content updates, Advanced Trauma Life Support version 10 adopted contemporary learning theory and practice into the format and conduct of the training. MethodsThe study used a mixed-methods approach wherein a one-group post-test–only study of student and student refresher exam score differences was followed up with a faculty survey to qualitatively explore the quantitative findings. Mann-Whitney U tests were used to test the null hypotheses that student and student refresher test scores on version 9 (2018) and version 10 (2019) were the same. χ2 tests of independence were conducted to test the null hypotheses that student and student refresher initial assessment pass rates under versions 9 and 10 were the same. Faculty survey responses were analyzed descriptively. ResultsFor the student written tests, the null hypothesis was retained. For the student refresher written tests the null hypothesis was rejected; the 2019 cohort performed worse than the 2018 cohort. Student initial assessment and student refresher initial assessment pass rates in 2018 and 2019 were statistically the same. The majority of faculty reported less motivation for teaching version 10. ConclusionAlthough a quadrennial review of the format and conduct of Advanced Trauma Life Support courses above and beyond content updates is appropriate, it may be prudent to require strong evidence of improved student performance and value before implementing changes to the training.

Advanced Trauma Life Support Course Delivery: Comparison of Outcomes From Modifications During Covid-19.

IntroductionThe Advanced Trauma Life Support (ATLS) Course is a two-day long medical training course developed by the American College of Surgeons (ACS) to help train and prepare healthcare providers to care for severely injured patients. The coronavirus disease 2019 (COVID-19) pandemic has resulted in the modification or cancellation of many education programs across the world. At the University of South Florida’s Center for Advanced Medical Learning and Simulation (CAMLS) two different models of ATLS were delivered in response to the COVID-19 pandemic with both models utilizing the ACS’s online mobile ATLS (mATLS). In this study three different models of ATLS delivered by USF CAMLS between 2019 and 2020 were compared to determine if there were any impacts on the education and functionality of the ATLS course between the three different models of ATLS: a baseline ATLS course, an augmented ATLS course that used mATLS, and an ATLS course that used mATLS as a replacement for in-person lectures.Material and methodsTo compare the three models of ATLS delivery, a total of six ATLS courses were studied: a baseline face-to-face ATLS course from June 2019, two Mobile ATLS (mATLS) courses from September 2020, and three augmented ATLS courses that contained both face-to-face and mATLS delivery from October, November and December 2020. The only differences between the traditional ATLS courses from 2020 and the pre-COVID ATLS course from 2019 were that the courses from 2020 utilized mATLS and that the course days were longer due to cleaning time. These courses were selected to have a non-significant difference in the number of learners in each model of ATLS course. The data that were collected from these courses included: post-test results from learners, learner feedback surveys, and interviews with the ATLS Course Director, ATLS Course Coordinator, and the Educational Coordinator.ResultsThe only courses with significant differences in the post-test mean scores were for the baseline ATLS course compared to the mATLS courses. The augmented courses showed similar post-test performance to the mATLS courses. Students viewed the courses favorably with the only major complaint between the 2019 and the 2020 courses being a high amount of downtime for the 2020 courses due to time required to disinfect skill stations and equipment. The main difficulties for the ATLS Course Director, ATLS Course Coordinator, and the Educational Coordinator with the ATLS courses in 2020 were concerned with challenges from COVID-19, like social distancing, and not with mATLS or the shortened instruction time with the hybrid model.DiscussionThis preliminary study analyzed three delivery models of ATLS. The mATLS may be able to replace in-person lectures of ATLS courses as courses using alternative delivery formats showed post-test scores as good or better than the baseline face-to-face course.

The Effectiveness of Simulation Training in an Advanced Trauma Life Support Program for General Surgery Residents: A Pilot Study

Purpose: Although the Advanced Trauma Life Support (ATLS) course is now taught internationally, it has not been implemented in Korea. In recent years, interest has increased in simulation as a teaching tool in the ATLS course. We therefore hypothesized that simulation training would be a useful adjunct to the ATLS course. Methods: We designed a 1-day curriculum that included skill development workstations, expert lectures, trauma patient simulations, and group discussion for general surgery residents. We conducted a survey to evaluate participants’ level of understanding of the initial evaluation and treatment of trauma patients, their degree of knowledge and technical improvement, their satisfaction with the learning goals, and their overall satisfaction with the curriculum. We then analyzed the effects before and after the training. Results: Nine residents attended this course. None of the residents initially reported that they could perform a primary survey of trauma patients. The analysis revealed significant improvements after training in the questionnaire areas of “assembly of the team and preparation for resuscitation of a trauma patient” (p=0.008), “performance of a primary survey for trauma patients” (p=0.007), “resuscitative procedures for trauma patients” (p=0.008), “importance of re-evaluation” (p=0.007), “identifying the pitfalls associated with the initial assessment and management” (p=0.007), and “importance of teamwork” (p=0.007). Conclusions: After the ATLS simulation training, all participants showed significant improvements in their understanding of how to manage multiple trauma patients. Therefore, ATLS simulation training for residents will help in the management of trauma patients.

Pediatric trauma primary survey performance among surgical and non-surgical pediatric providers in a Brazilian trauma center

IntroductionTrauma is the leading cause of death and disability among Brazilian children and adolescents. Trauma protocols such as those developed by the Advanced Trauma Life Support course are widely taught,...

Formalin embalmed cadavers are effective training tools for hands-on skills training of combat advanced trauma life support course (C-ATLS)

Introduction: Use of cadavers as replacement of mannequins has been practiced since many years now and they are more suitable in resource scarce societies where cadavers are available. Cadavers that are used for the purpose of anatomy teaching at undergraduate level can be used for hands on training of various clinical and procedural skills. We describe the finding of a hands on workshop on procedural skills conducted at our institute. Methodology: During hands on session of combat advanced trauma life support course (C-ATLS), procedural skills Tracheostomy, Colostomy, Diagnostic Peritoneal Lavage, Suprapubic Catheter Insertion, Tube Thoracostomy, Pericardiocentesis, Venesection and Application of External Fixator were taught using traditionally embalmed human cadavers. Structured and non-structured feedbacks from both facilitators of the course and participants were obtained to assess the suitability of cadavers for skills training. Results: Most facilitators and participants responded that use of cadavers in the skills training was suitable as per the learning objectives and needs. Some drawbacks of using these cadavers were also noted. Conclusion: Traditionally fixed human cadavers can be effectively used for hands on training program of procedural skills of C-ATLS.

Massive transfusion in The Netherlands

ObjectivesMassive transfusion protocols (MTPs) may improve survival in patients with uncontrolled haemorrhage. An MTP was introduced into the Dutch transfusion guidelines in 2011, the ninth edition of the advanced trauma...

Efficacy of a Novel Surgical Manikin for Simulating Emergency Surgical Procedures

The practical component of the Advanced Trauma Life Support (ATLS®) course typically includes a TraumaMan® manikin. This manikin is expensive; hence, a low-cost alternative (SurgeMan®) was developed in Brazil. Our primary objective was to compare user satisfaction among SurgeMan, TraumaMan, and porcine models during the course. Our secondary objective was to determine the user satisfaction scores for SurgeMan. This study included 36 ATLS students and nine instructors (4:1 ratio). Tube thoracostomy, cricothyroidotomy, pericardiocentesis, and diagnostic peritoneal lavage were performed on all the three models. The participants then rated their satisfaction both after each activity and after the course. The porcine and TraumaMan models fared better than SurgeMan for all skills except pericardiocentesis. In the absence of ethical or financial constraints, 58 per cent of the students and 66 per cent of the instructors indicated preference for the porcine model. When ethical and financial factors were considered, no preference was evident among the students, whereas 66 per cent of instructors preferred SurgeMan over the others. The students gave all three models an overall adequacy rating of >80 per cent; the instructors gave only the animal models an adequacy rating of <80 per cent. Although the users were more satisfied with TraumaMan than with SurgeMan, both were considered acceptable for the ATLS course.