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

University of Western Ontario Medical Journal ◽

10.5206/uwomj.v89i2.10260 ◽

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.

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Effect of the Advanced Trauma Life Support Program on Medical Students' Performance in Simulated Trauma Patient Management

The Journal of Trauma: Injury, Infection, and Critical Care ◽

10.1097/00005373-199804000-00005 ◽

1998 ◽

Vol 44 (4) ◽

pp. 588-591 ◽

Cited By ~ 59

Author(s):

Jameel Ali ◽

Robert J. Cohen ◽

Theophilus J. Gana ◽

Khaled F. Al-Bedah

Keyword(s):

Medical Students ◽

Trauma Patient ◽

Patient Management ◽

Life Support ◽

Support Program ◽

Advanced Trauma Life Support

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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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A proposed novel algorithmic approach to the evaluation of the acutely injured trauma patient: should advanced trauma life support incorporate biomarkers?

The American Journal of Emergency Medicine ◽

10.1016/j.ajem.2013.11.048 ◽

2014 ◽

Vol 32 (3) ◽

pp. 282-284

Author(s):

Nicholas D. Caputo ◽

Marc Kanter

Keyword(s):

Trauma Patient ◽

Life Support ◽

Advanced Trauma Life Support ◽

Algorithmic Approach

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

10.21203/rs.3.rs-147008/v1 ◽

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.

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Assessment of the maxillofacial patientMaxillofacial trauma and ATLS®

10.1093/med/9780199682874.003.0071 ◽

2021 ◽

pp. 789-792

Author(s):

Christopher J. Mannion

Keyword(s):

Trauma Patient ◽

Systematic Approach ◽

Life Support ◽

Facial Trauma ◽

Advanced Trauma Life Support ◽

Specific Assessment ◽

Ocular Injuries

The assessment of the facial trauma patient requires a systematic approach with initial emphasis given to the principles of the Advanced Trauma Life Support® programme. Specific assessment of injury to the maxillofacial skeleton and associated ocular injuries are also described in this chapter.

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

10.21203/rs.3.rs-102622/v1 ◽

2020 ◽

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 ◽

Significant Finding ◽

Education Programs ◽

Missed Injuries ◽

Polytrauma Patients ◽

Trauma Education

Abstract Introduction: Trauma 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.Aim: Improve 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.Methods: This interventional training study was conducted in the SCUH ED. 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.Results: Overall, 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.Conclusion: STEPs 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.

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