Sechs Jahre Advanced Trauma Life Support (ATLS) in Deutschland

2010 ◽  
Vol 113 (7) ◽  
pp. 561-567 ◽  
Author(s):  
M. Münzberg ◽  
L. Mahlke ◽  
B. Bouillon ◽  
T. Paffrath ◽  
G. Matthes ◽  
...  
Keyword(s):  
Life Support ◽  
Advanced Trauma Life Support

Case Report: FAST Ultrasound Interpretation in Trauma Resuscitation

POCUS Journal ◽  
2016 ◽  
Vol 1 (3) ◽  
pp. 13-14
Author(s):  
Stuart Douglas, PGY4 ◽  
Joseph Newbigging, MD ◽  
David Robertson, MD
Keyword(s):  
Case Report ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Life Support ◽  
Advanced Trauma Life Support ◽  
Trauma Patients ◽  
Ultrasound Probe ◽  
Trauma Resuscitation ◽  
Highly Sensitive ◽  
Pouch Of Douglas

FAST Background: Focused Assessment with Sonography for Trauma (FAST) is an integral adjunct to primary survey in trauma patients (1-4) and is incorporated into Advanced Trauma Life Support (ATLS) algorithms (4). A collection of four discrete ultrasound probe examinations (pericardial sac, hepatorenal fossa (Morison’s pouch), splenorenal fossa, and pelvis/pouch of Douglas), it has been shown to be highly sensitive for detection of as little as 100cm3 of intraabdominal fluid (4,5), with a sensitivity quoted between 60-98%, specificity of 84-98%, and negative predictive value of 97-99% (3).

Pediatric Emergency Medicine: A Developing Subspecialty

PEDIATRICS ◽  
1989 ◽  
Vol 84 (2) ◽  
pp. 336-342
Author(s):  
Marilyn Li ◽  
M. Douglas Baker ◽  
Leland J. Ropp
Keyword(s):  
Emergency Medicine ◽  
Emergency Care ◽  
Emergency Departments ◽  
Life Support ◽  
Pediatric Emergency ◽  
Advanced Trauma Life Support ◽  
Full Time ◽  
Pediatric Emergency Medicine ◽  
Pediatric Hospitals ◽  
Pediatric Emergency Care

Questionnaires were sent to 245 North American institutions with pediatric residency programs. There was a 69% response rate. Pediatric emergency care is provided in three types of facilities: emergency departments in pediatric hospitals, separate pediatric emergency departments or combined pediatric and adult emergency departments, in multidisciplinary hospitals. There are at least 262 pediatricians practicing full-time pediatric emergency medicine. The majority work in pediatric emergency departments, an average of 30.7 clinical hours per week. There are 27 pediatric emergency medicine programs with 46 fellows in training and 117 full-time positions available for emergency pediatricians throughout North America. Varying qualifications for these positions include board eligibility in pediatrics, certification in Basic Life Support or Advanced Trauma Life Support, and a fellowship in pediatric emergency medicine. The demonstrated need for pediatricians, preferably trained in emergency care, clearly indicates that pediatric emergency medicine is a rapidly developing subspecialty of Pediatrics that will be an attractive career choice for future pediatricians.

Injuries to the Neck

2015 ◽  
Author(s):  
David H. Wisner ◽  
Joseph M. Galante
Keyword(s):  
Vertebral Artery ◽  
Carotid Arteries ◽  
Life Support ◽  
Jugular Vein ◽  
Penetrating Trauma ◽  
Operative Management ◽  
Advanced Trauma Life Support ◽  
Neck Trauma ◽  
Anatomical Structures ◽  
Initial Management

Injuries to the neck can be the result of blunt and penetrating trauma. Both mechanisms can cause devastating injuries, with high associated rates of morbidity and mortality. Airway management in trauma does not differ based on the mechanism of injury, and so the initial priority is to ensure an adequate airway through cricothyrotomy or tracheotomy. For penetrating neck trauma, initial management is evaluated in accordance with Advanced Trauma Life Support (ATLS) guidelines. Thereafter, the management of penetrating trauma of the stable patients is provided and includes carotid artery exploration and repair, vertebral artery exploration and repair, endovascular repair, jugular vein injuries, treatment of the pharynx and esophagus, and treatment of the larynx and trachea. Blunt trauma is described and includes injuries to the aerodigestive tract and cerebrovascular and vertebral injuries. Figures show an algorithm outlining operative management of known or suspected injuries to the carotid arteries, jugular vein, pharynx, and esophagus; the three separate zones of the neck; common incisions made along the sternocleidomastoid muscle; important anatomical structures of the neck; and an algorithm outlining management of known injuries to the vertebral artery. This chapter contains 31 references.

Disaster Reanimatology Potentials: A Structured Interview Study in Armenia I. Methodology and Preliminary Results

1989 ◽  
Vol 4 (2) ◽  
pp. 135-152 ◽  
Author(s):  
Miroslav Klain ◽  
Edmund Ricci ◽  
Peter Safar ◽  
Victor Semenov ◽  
Ernesto Pretto ◽  
...  
Keyword(s):  
Intensive Care ◽  
Life Support ◽  
Medical Personnel ◽  
The United States ◽  
Structured Interview ◽  
Advanced Trauma Life Support ◽  
Mass Casualties ◽  
Medical Systems ◽  
Preliminary Results ◽  
Medical Teams

AbstractIn general, preparations for disasters which result in mass casualties do not incorporate a modern resuscitation approach. We explored the life-saving potential of, and time limits for life-supporting first aid (LSFA), advanced trauma life support (ATLS), resuscitative surgery, and prolonged life support (PLS: intensive care) following the earthquake in Armenia on 7 December 1988. We used a structured, retrospective interview method applied previously to evaluation of emergency medical services (EMS) in the United States. A total of 120 survivors of, and participants in the earthquake in Armenia were interviewed on site (49 lay eyewitnesses, 20 search-rescue personnel, 39 medical personnel and records, and 12 administrators). Answers were verified by crosschecks. Preliminary results permit the following generalizations: 1) a significant number of victims died slowly as the result of injuries such as external hemorrhage, head injury with coma, shock, or crush syndrome; 2) early search and rescue was performed primarily by uninjured covictims using hand tools; 3) many lives potentially could have been saved by the use of LSFA and ATLS started during extrication of crushed victims. 4) medical teams from neighboring EMS systems started to arrive at the site at 2-3 hours and therefore, A TLS could have been provided in time to save lives and limbs; 5) some amputations had to be performed in the field to enable extrication; 6) the usefulness of other resuscitative surgery in the field needs to be clarified; 7) evacuations were rapid; 8) air evacuation proved essential; 9) hospital intensive care was well organized; and 10) international medical aid, which arrived after 48 hours, was too late to impact on resuscitation. Definitive analysis of data in the near future will lead to recommendations for local, regional, and National Disaster Medical Systems (NDMS).

scholarly journals Impact of Implementation of Sequential Trauma Education Programs (STEPs) Course on Missed Injuries in Emergency Polytrauma Patients, Ismailia, Egypt

2021 ◽  
Author(s):  
Adel Hamed Elbaih ◽  
Maged El-Setouhy ◽  
Jon Mark Hirshon ◽  
Hazem Mohamed El-Hariri ◽  
Mohamed El-Shinawi
Keyword(s):  
Low Income ◽  
Life Support ◽  
University Hospital ◽  
Low Income Countries ◽  
Advanced Trauma Life Support ◽  
Trauma Patients ◽  
Education Programs ◽  
Missed Injuries ◽  
Polytrauma Patients ◽  
Trauma Education

Abstract IntroductionTrauma deaths account for 8% of all deaths in Egypt. Patients with multiple injuries are at high risk but may be saved with a good triage system and a well-trained trauma team in dedicated institutions. The incidence of missed injuries in the Emergency Department (ED) of Suez Canal University Hospital (SCUH) was found to be 9.0% after applying Advanced Trauma Life Support (ATLS) guidelines. However, this rate is still high compared with many trauma centers.AimImprove the quality of management of polytrauma patients by decreasing the incidence of missed injuries by implementing the Sequential Trauma Education Programs (STEPs) course in the ED at SCUH.MethodsThis interventional training study was conducted in the SCUH ED that adheres to CONSORT guidelines. The study was conducted during the 1-month precourse and for 6 months after the implementation of the STEPs course for ED physicians. Overall, 458 polytrauma patients were randomly selected, of which 45 were found to have missed injuries after applying the inclusion and exclusion criteria. We assessed the clinical relevance of these cases for missed injuries before and after the STEPs course.ResultsOverall, 45 patients were found to have missed injuries, of which 15 (12%) were pre-STEPs and 30 (9%) were post-STEPs course. The STEPs course significantly increased adherence to vital data recording, but the reduction of missed injuries (3.0%) was not statistically significant in relation to demographic and trauma findings. However, the decrease in missed injuries in the post-STEPs course group was an essential clinically significant finding.ConclusionSTEPs course implementation decreased the incidence of missed injuries in polytrauma patients. Thus, the STEPs course can be considered at the same level of other advanced trauma courses as a training skills program or possibly better in dealing with trauma patients. Repetition of this course by physicians should be mandatory to prevent more missed injuries. Therefore, the validation of STEPs course certification should be completed at least every 2 years to help decrease the number of missed injuries, especially in low-income countries and low-resource settings.Trial RegistrationProject manager for the Pan African Clinical Trial Registry (www.pactr.org) database has been accepted with the date of approval:18/11/2020. Current Controlled Trials number for the registry is PACTR202011853914203. Please note that the article state Retrospectively registered that my study adheres to CONSORT guidelines.

scholarly journals The Diagnostic Peritoneal Lavage: A Brief Review of the Current Literature and an Analysis of Its use and Teaching in Canada

2012 ◽  
Vol 1 (3) ◽  
pp. 150-153
Author(s):  
Colin A Clarkson ◽  
Darrell Boone
Keyword(s):  
Current Literature ◽  
General Surgery ◽  
Life Support ◽  
Peritoneal Lavage ◽  
Motor Vehicle ◽  
Penetrating Trauma ◽  
Advanced Trauma Life Support ◽  
Published Data ◽  
Grey Zone ◽  
Diagnostic Peritoneal Lavage

ABSTRACT Introduction The vast majority of the published data on the appropriate use of the diagnostic peritoneal lavage (DPL) is dated. Currently in Canada, there is a significant grey-zone surrounding the teaching and use of the DPL. The objectives of this article are to briefly review the recent literature, to analyze the patterns in the use of the DPL in Canada, and to determine whether general surgery residents are being taught the skill. Methods Literature review was conducted using PubMed and Ovid. The Canadian Institute for Health Information (CIHI) supplied the available data on DPL usage in Canada. General surgery program directors in Canada were contacted by e-mail to determine if the DPL was still being taught. Results Between the years of 2001 and 2006 in Canada, 38 DPLs were coded into the CIHI's database. Males accounted for 84.2% of the DPLs, and 23.7% of all DPLs resulted in a laparotomy. Motor vehicle crashes were the reason that 42% of the DPLs were performed. The majority of general surgery residency programs in Canada are not teaching the DPL outside of what is taught in the advanced trauma life support (ATLS) course. Discussion The literature reviewed shows that the DPL continues to play a role in the current management of patients suffering from both blunt and penetrating trauma, although a much more limited role than in the past. How to cite this article Boone D, Clarkson CA. The Diagnostic Peritoneal Lavage: A Brief Review of the Current Literature and an Analysis of Its use and Teaching in Canada. Panam J Trauma Critical Care Emerg Surg 2012;1(3):150-153.

scholarly journals Dr. James Styner and the development of Advanced Trauma Life Support

2021 ◽  
Author(s):  
Wesley Tin
Keyword(s):  
Trauma Patient ◽  
Educational System ◽  
Education System ◽  
Life Support ◽  
Standard Of Care ◽  
Support Program ◽  
Advanced Trauma Life Support ◽  
Significant Morbidity ◽  
Initial Management ◽  
Trauma Education

The Advanced Trauma Life Support program, or ATLS, is a trauma education system that has become the standard of care for initial management in emergent settings. Trauma is responsible for 10% of the world’s mortality, and comes at extensive cost, often with significant morbidity and rehabilitation1. ATLS provides an organized language and approach to the trauma patient that can be communicated globally and has been shown to significantly decrease mortality in the first hour post-admission2. It was originally designed for use in low resource settings after a devastating accident involving an orthopaedic surgeon’s family. The shortcomings in care that his family received spurred him to create an educational system that could be applied at any site.

scholarly journals The rescue of the polytraumatized victims due to violence in transit in the city of Chapecó-SC: the “golden hour”

2020 ◽  
Vol 13 (7) ◽  
pp. 102
Author(s):  
G. A. S. Moser ◽  
D. C. M. Aguiar ◽  
B. C. Franciscon ◽  
J. F. Lima ◽  
F. B. Haag
Keyword(s):  
Customer Service ◽  
Hospital Care ◽  
Life Support ◽  
Fire Department ◽  
Modern Society ◽  
Advanced Trauma Life Support ◽  
Structured Interviews ◽  
The West ◽  
Golden Hour ◽  
Delay Of Care

Trauma is considered the third cause of death, being understood as a disease with endemic character in modern society is not only affecting the field of public health, but also, the socio-political society. According to the Advanced Trauma Life Support - ATLS, in emergencies, the first hour, called the "Golden Hour" (Golden hour), this is the moment in which more deaths occur. However, this is also the time for more if you can avoid them. This study aimed to understand how the pre-hospital care and hospital conducted both by the Fire Department of the west of SC, and by nurses from the emergency department of a regional hospital in the west of Santa Catarina, whereas the reception and customer service in the first hour of trauma ("golden hour") the polytraumatized patients. It is a qualitative, with data collection in the first half of October 2016, through semi structured interviews held with nine Militarized Firemen and four nurses to an emergency room, using as analytical method to Content Analysis of Bardin. In this study, it was observed that within 60 minutes that comprise the golden hour, first medical care which is since the so-called redemption until the reached the hospital, is done quickly and properly in most of the times, ignoring the factors that may delay the answer, as transit, incarceration and away from the occurrence, being the victim transported in a timely manner. This delay in care is often caused by delay of complementary examinations, delay of care by the medical team, deficiency of structure and overcrowding, these factors generate a cascade of delay, which consequently worsen the situation of the patient, increasing morbidity and mortality. You will notice that the golden hour is valuable in that it concerns the maintenance of life and consequences for patients. A quick and effective way can increase the chances of survival of same. It is known that the development of services of APH, whether public or private, culminate with the need for trained and qualified professionals that meet the specific needs of the nursing care during the pre-hospital care, with a view to prevention, protection and recovery to healthIt is of great importance to discuss more about the topic and conduct further studies to develop mechanisms that reduce this time-response thus lowering the risk of sequelae and mortality due to trauma.

scholarly journals Knowledge and Proficiency in Skills of Initial Trauma Management among Healthcare Personnel in Secondary Care

2020 ◽  
Vol 3 (1) ◽  
pp. 267-271
Author(s):  
HY Embu ◽  
SI Nuhu ◽  
SP Bishmang
Keyword(s):  
Airway Management ◽  
Respiratory Distress ◽  
Trauma Care ◽  
Secondary Care ◽  
Life Support ◽  
Healthcare Personnel ◽  
Advanced Trauma Life Support ◽  
Trauma Management ◽  
Management Skills ◽  
North Central

Advanced Trauma Life Support (ATLS) protocols aim to provide good trauma care by enhancing the skills of medical personnel all over the world and while this is well established in developed countries it does not appear to be so in developing countries. This study aims to assess the knowledge and proficiency in initial trauma management skills among health caregivers in some general/cottage hospitals in north central Nigeria. Questionnaires were developed to assess the knowledge and skills of care givers in airway management, respiratory distress and shock. The questionnaires were administered on caregivers involved in trauma care in some general/cottage hospitals that offer secondary care in a state in north-central Nigeria. There were 34 health workers who responded, 10 (29.41%) were doctors and 24(70.54%) were nurses. Their years of experience were from 2 to 35 years (median 14years). Ten (29.41%) had at least one training in ATLS in the past while 24(70.59%) had none. In assessing their management skills, 97.06% reported they were able to assess the airway, 88.24% could do chin lift, 73.53% jaw thrust while 91.18% were able to insert oral airway. Thirty-one (91.18%) were able to recognize respiratory distress, 88.24 were able to administer oxygen using facemask and 64.71% using nasal prong. Thirty (88.24%) could assess a patient for shock, 82.35% could splint fractures for haemorrhage control. Twenty-seven (79.41%) reported knowing parameters to monitor during resuscitation. We concluded that knowledge of airway management was high but proficiency and confidence in performing these skills were low.

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