Advanced Trauma Life Support instructor training in the UK: an evaluation.

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.

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ATLS®: breaking new ground

Bulletin of The Royal College of Surgeons of England ◽

10.1308/147363513x13690603819461 ◽

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.

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

Prehospital and Disaster Medicine ◽

10.1017/s1049023x11002056 ◽

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.

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

British Journal of Surgery ◽

10.1093/bjs/znab311.010 ◽

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.

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Surgical curriculum concordance: requiem for the educational dream

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2020-139385 ◽

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.

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Launch of the ATLS® 8th edition

Bulletin of The Royal College of Surgeons of England ◽

10.1308/147363509x413266 ◽

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.

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Case Report: FAST Ultrasound Interpretation in Trauma Resuscitation

POCUS Journal ◽

10.24908/pocus.v1i3.13263 ◽

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).

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Sechs Jahre Advanced Trauma Life Support (ATLS) in Deutschland

Der Unfallchirurg ◽

10.1007/s00113-010-1765-0 ◽

2010 ◽

Vol 113 (7) ◽

pp. 561-567 ◽

Cited By ~ 13

Author(s):

M. Münzberg ◽

L. Mahlke ◽

B. Bouillon ◽

T. Paffrath ◽

G. Matthes ◽

...

Keyword(s):

Life Support ◽

Advanced Trauma Life Support

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Pediatric Emergency Medicine: A Developing Subspecialty

PEDIATRICS ◽

10.1542/peds.84.2.336 ◽

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.

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Injuries to the Neck

10.2310/neuro.2132 ◽

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.

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