ATLS Versus ETC: Time for a Decision?

Are Spanish surgeons prepared to treat trauma patients? Multicentre descriptive observational study

PURPOSE

Specific training in the management of trauma patients is beneficial for surgeons. Training through specific courses in this area has a direct impact on the care of these patients. The aim of this work is to understand the participation and specific training in the care of trauma patients by Spanish surgeons.

METHODS

A national survey was conducted and administered to all members of the Spanish Association of Surgeons. The survey assessed their degree of participation in emergency surgery, and therefore the probability of attending trauma patients, their assessment of the initial care of trauma patients in their centre, and their specific training in this field.

RESULTS

The survey was completed by 510 surgeons from 47 Spanish provinces, with Catalonia and Andalusia being the most represented regions. In total, 456 (89.41%) of those surveyed work in the emergency department on a routine basis. Only 171 (33.53%) refer to having a registry of trauma patients in their hospital. While 79.02% of surgeons reported that general surgeons are not involved in care of severe trauma from the outset, only 66.47% have completed the ATLS course, 40.78% the DSTC course and 18.82% the MUSEC course. Despite this, 85.69% believe that the ATLS course should be compulsory during residency and 43.33% believe that severe trauma care in their hospital is poor or very poor.

CONCLUSION

Only 40% have received specific training in definitive surgical management of severe trauma. Despite this, a large percentage of surgeons work in the emergency department on a routine basis and potentially face the challenge of managing these patients.

Trauma surgery: discipline in crisis

Throughout the past quarter century, there have been slow but dramatic changes in the nature and practice of trauma surgery, and this field increasingly faces potent economic, logistic, political, and workforce challenges. Patients and emergency physicians have much to lose by this budding crisis in our partner discipline. This article reviews the specific issues confronting trauma surgery, their historical context, and the potential directions available to this discipline. Implications of these issues for emergency physicians and for trauma care overall are discussed.

Teaching the trauma teachers: an international review of the Advanced Trauma Life Support Instructor Course

OBJECTIVES

To identify educational variations between Advanced Trauma Life Support (ATLS) Instructor Courses in the UK, USA and Australia, to determine the impact of any such variations, and to consider their contributory role in future course development.

METHODS

Observational, participatory qualitative study of ATLS Instructor Courses held in three representative teaching centres in 2006 and 2007.

RESULTS

Each international territory has developed individual approaches to the teaching of common course content. These approaches have a variable impact upon the educational efficacy of the course.

CONCLUSIONS

Observation of educational practice in international course centres allows for a richer understanding of the nature and extent of variations in teaching methods and course organisation. The amalgamation of these variations will facilitate a more inclusive international common platform for the 8th edition Instructor Course.