scholarly journals EP.TU.54Surgical curriculum concordance: requiem for the educational dream

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Oliver Luton ◽  
Osian James ◽  
Katie Mellor ◽  
Catherine Eley ◽  
Richard Egan ◽  
...  
Keyword(s):  
Life Support ◽  
Advanced Trauma Life Support ◽  
Regulatory Body ◽  
Surgical Skill ◽  
Relative Variation ◽  
Learned Societies ◽  
Minimum Number ◽  
Academic Competencies ◽  
The Uk ◽  
Competency Domains

Abstract Aim This study aimed to analyse the degree of relative variation in specialty-specific competencies required for Certification of Completion of Training (CCT) set by the UK Joint Committee for Surgical Training (JCST) 2021 curriculum. Methods Regulatory body guidance related to operative and non-operative surgical skill competencies required for CCT were analysed and compared. Results Wide inter-speciality variation was demonstrated in the minimum number of logbook cases (median 815; range 54-2100), indexed operations (8; 5-24), Procedure Based Assessments (35; 6-110). Academic competencies related to peer reviewed publications, communications to learned societies, and audits were aligned at zero, zero, and three across specialties respectively. Mandatory courses have been standardised with Advanced Trauma Life Support (ATLS) being the sole pre-requisite CCT for all. Discussion JCST certification guidelines have broadly standardised competency domains, yet large discrepancies persist regarding operative indicative numbers, and assessments. This article serves as a definitive CCT guide regarding prevailing changes.

Surgical curriculum concordance: requiem for the educational dream

2021 ◽  
pp. postgradmedj-2020-139385
Author(s):  
Oliver Luton ◽  
Osian Penri James ◽  
Katie Mellor ◽  
Arfon Powell ◽  
Luke Hopkins ◽  
...  
Keyword(s):  
Life Support ◽  
Advanced Trauma Life Support ◽  
Regulatory Body ◽  
Surgical Skill ◽  
Relative Variation ◽  
Learned Societies ◽  
Minimum Number ◽  
Academic Competencies ◽  
The Uk ◽  
Competency Domains

This study aimed to analyse the degree of relative variation in speciality-specific competencies required for Certification of Completion of Training (CCT) set by the UK Joint Committee for Surgical Training (JCST) 2021 curriculum. Regulatory body guidance related to operative and non-operative surgical skill competencies required for CCT were analysed and compared. Wide inter-speciality variation was demonstrated in the minimum number of logbook cases (median 815; range 54 to 2100), indexed operations (8; 5 to 24) and procedure-based assessments (35; 6 to 110). Academic competencies related to peer-reviewed publications, communications to learned societies and audits were aligned at zero, zero and three across specialities, respectively. Mandatory courses have been standardised with Advanced Trauma Life Support being the sole pre-requisite CCT for all. JCST certification guidelines have broadly standardised competency domains, yet large discrepancies persist regarding operative indicative numbers and assessments. This article serves as a definitive CCT guide regarding prevailing changes.

Trauma surgery

2014 ◽  
Author(s):  
Sebastian Dawson-Bowling ◽  
Serena Ledwidge
Keyword(s):  
Life Support ◽  
Trauma Surgery ◽  
Clinical Signs ◽  
Tension Pneumothorax ◽  
Trauma Team ◽  
Definitive Treatment ◽  
Advanced Trauma Life Support ◽  
Mortality And Morbidity ◽  
Golden Hour ◽  
The Uk

Appreciation of the ‘golden hour’ for resuscitation, and adoption of prin­ciples of the advanced trauma life support (ATLS) system are key factors in improving outcome for the patient with major injuries. Adherence to the strict protocols of the ABCDEs of the primary survey enables the trauma team to identify and deal with life-threatening conditions, prior to definitive treatment of problems with lesser immediacy. The clinician who understands the mechanism of injury will main­tain heightened levels of suspicion for clinical signs which point to well-recognized conditions resulting in early mortality and morbidity, for instance, tension pneumothorax, cardiac tamponade, and rising intrac­ranial pressure. This chapter will probe your grasp of the principles of trauma manage­ment. You will also be tested on common patterns of thoracic, abdomi­nal, vascular, and cranial injuries. Whilst clinical presentations of civilian trauma have remained consist­ent in recent years, the impact of military trauma in worldwide theatres of conflict has stimulated numerous advances in the management of trauma. The current impetus for reorganization of trauma services in the UK is tacit acknowledgement of the improvement in outcomes that can be achieved by adherence to recognized protocols in this challenging and demanding field of surgery.

scholarly journals ATLS®: breaking new ground

2013 ◽  
Vol 95 (10) ◽  
pp. 333-333
Author(s):  
Stephen Bush
Keyword(s):  
Differential Diagnosis ◽  
Life Support ◽  
Medical Training ◽  
Trauma Team ◽  
Advanced Trauma Life Support ◽  
Generic Skills ◽  
The Uk

The inaugural Advanced Trauma Life Support (ATLS)® course was run in the UK in 1988 and now over 50 countries worldwide run an ATLS® programme and over a million doctors have been trained. In the early days of ATLS®, its message was ground-breaking. It introduced the ABCDE approach, the generic skills of the trauma team and goal directed care. At the time, this message was at significant odds with the accepted model of history, examination, differential diagnosis, investigation, refinement of the differential and then treatment. It is a testament to the effect that the ATLS® programme has had on medical training throughout the globe that this approach is now the convention.

scholarly journals (A215) Delayed Diagnosis of Injury in Survivors of the February 2009 Crash of Flight TK 1951

2011 ◽  
Vol 26 (S1) ◽  
pp. s59-s60
Author(s):  
I.L.E. Postma ◽  
J. Winkelhagen ◽  
T. Bijlsma ◽  
F. Bloemers ◽  
M. Heetveld ◽  
...  
Keyword(s):  
Injury Severity ◽  
Life Support ◽  
Delayed Diagnosis ◽  
Advanced Trauma Life Support ◽  
Trauma Patients ◽  
Emergency Intervention ◽  
Plane Crash ◽  
Tertiary Survey ◽  
Clinically Significant ◽  
The Uk

IntroductionIn 2009, a Boeing 737 crashed near Amsterdam, traumatically injuring 126 people. In trauma patients, some injuries initially escape detection. The aim of this study is to evaluate the incidence of Delayed Diagnosis of Injury (DDI) and the effects of tertiary survey on the victims of a plane crash.MethodsData collected included documentations of DDI, tertiary surveys, Injury Severity Scale (ISS) score, Glasgow Coma Scale score, number and type of injuries, and emergency intervention. Clinically significant injuries were separated from non-clinically significant injuries. Comparison was made to a crash in the UK (1989), before advanced trauma life support became practiced widely.ResultsAll 126 victims were evaluated in a hospital emergency department; 66 were admitted with a total of 171 clinically significant injuries. Twelve clinically significant DDIs were found in eight patients (12%). In 65%, a tertiary survey was documented. The DDI incidences differed for several risk factors. Eighty-one survivors of the UK crash had a total of 332 injuries. Of those with > 5 injuries, 5% had a DDI, versus 8% of those with ≤ 5 injuries.ConclusionsThe DDI incidence in this study was 7% of the injuries in 12% of the population. A tertiary survey was documented in 65%; ideally this should be 100%. In this study, a high ISS score, head injury, > 5 injuries, and emergency intervention were associated with DDI. The DDI incidence in the current study was lower than in the UK crash.

Launch of the ATLS® 8th edition

2009 ◽  
Vol 91 (3) ◽  
pp. 84-85
Author(s):  
Rosalind Roden
Keyword(s):  
Gold Standard ◽  
Major Trauma ◽  
Life Support ◽  
Advanced Trauma Life Support ◽  
Common Language ◽  
Early Management ◽  
Wide Range ◽  
Eighth Edition ◽  
The Uk ◽  
8Th Edition

On 27 March 2009 The Royal College of Surgeons of England will host the launch of the eighth edition of the Advanced Trauma Life Support® (ATLS®) programme in the UK. ATLS® has just entered its 21st year of life in the UK. The courses are run in 120 regional centres and in 2008 trained over 4,200 providers. ATLS® represents the gold standard for those involved in the early management of major trauma. The programme currently has over 600 active instructors from a wide range of specialties, including general surgery, emergency medicine, trauma and orthopaedics, anaesthesiology and radiology. More than anything ATLS® promotes a common language among those of us who work together to care for trauma victims.

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).

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

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.

Initiatives in UK Offshore Decommissioning Following the Wood Review: Applicability for Decommissioning in Norway

2021 ◽  
Author(s):  
Rune Vikane ◽  
Jon Tømmerås Selvik ◽  
Eirik Bjorheim Abrahamsen
Keyword(s):  
Swot Analysis ◽  
Oil And Gas ◽  
Petroleum Industry ◽  
Lessons Learned ◽  
Regulatory Regime ◽  
Regulatory Body ◽  
Cost Estimates ◽  
Substantial Impact ◽  
Gas Recovery ◽  
The Uk

Abstract The 2014 Wood Review is a report reviewing UK offshore oil and gas recovery and its regulation, led by Sir Ian Wood. The report identifies and addresses key challenges in the UK petroleum industry, among them the lack of a strong regulatory body and a decommissioning strategy. The UK petroleum industry is mature, and Norway may benefit from UK's experiences in decommissioning. The article investigates the applicability of the Wood Review recommendations for decommissioning in Norway. The analysis of the recommendations in the Wood Review is carried out by a SWOT-analysis of the general recommendations with a high potential impact on decommissioning as well as the five recommendations specific to decommissioning. The recommendations in the Wood Review were broadly accepted by UK authorities and formed the basis for numerous initiatives aimed at improving policies and practices in UK decommissioning. The key initiatives are presented to illustrate how the Wood Review recommendations has been interpreted. A summary of the key differences between the petroleum industries and the regulatory authorities in Norway and the UK is provided for background. Decommissioning in Norway face similar challenges to those identified in the Wood Review. The analysis indicates that several of the UK initiatives following the recommendations in the Wood Review has the potential of improving decommissioning in Norway. Differences in regulatory regimes between the regions may complicate the implementation of some of the initiatives following the Wood Review in Norway. In most cases only minor changes to regulations and/or practices are required. Recent UK initiatives with a high impact on decommissioning include increased focus on sharing of information and lessons learned, increased collaboration, the development of a decommissioning strategy, benchmarking of decommissioning cost estimates for all projects and the development and publishing of annual UK decommissioning cost estimates. There are indications that the Norwegian Petroleum Directorate (NPD) and the Norwegian Ministry of Petroleum and Energy (MPE) are falling behind their UK counterparts in key areas. Norway has limited experience with decommissioning, and scrupulous analysis of lessons learned in other regions is essential. Decommissioning of Norwegian offshore infrastructure is a major undertaking and even minor improvements may have a substantial impact on personnel risk, risk to the environment or the total decommissioning expenditure. The Norwegian regulatory regime has been an integral part of the Norwegian petroleum industry's success in previous decades, and changes to the regime require careful deliberation. The recent implementation of initiatives aimed at improving decommissioning regulations and practices in the UK represents a unique learning opportunity for Norwegian authorities. The analysis suggest that Norway may benefit from adopting some of the UK initiatives following the Wood Review recommendations.

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