This meeting was held at the Police General Hospital, 429 / 1 , Rama 1 Road, Patumwan,

BangKok., Thailand on Sunday 23rd August 2015. This meeting was run in conjunction with

the World Congress of Surgery.

Unfortunately, on the 17th August, in the lead up to the Region XV1 meeting, August, a bomb

exploded inside the grounds of the Erawan Shrine in the Bangkok city centre. Lives were lost

and many people injured. Following this tragedy, a decision needed to be made as to

whether the meeting should progress. Much of the organisation had been finalised and in

the face of this tragedy, the Thai ATLS family remained strong and were keen to go ahead

with the meeting and welcome all the visitors from the Region XV1 countries.

In acknowledgement of the tragedy a one minute silence was observed at the

commencement of the meeting.

Were received from the Hong Kong team and Saima Jamil ( Pakistan).

1. Welcome from Dr Michael Hollands and acknowledgement given to Dr Preecha and

Chulada and their team for all their hard work in organising the meeting in BangKok and for

the generous gift that was distributed to all at the meeting.

The meeting ran from about 0800am until 1600pm . The meeting attracted over 50 attendees. A/Prof Michael Hollands welcomed the delegates. Representatives from all regions except Hong Kong and India were in attendance with additional guests welcomed to the meeting: Dr Amy Thien, representing Brunei who are currently exploring the opportunity to bring ATLS into their country. Karen Brasel (International ATLS Chair),Sharon Henry,(ATLS Chair), Monique Drago(Trauma Educational Programs Manager ) and Germaine Suiza represented the ATLS Chicago office. The meeting included the Resident’s Paper Competition in the morning, followed by region updates and general interest sessions covering various aspects related to the conduct of ATLS course.

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There was a co-joint coordinator meeting conducted during the Resident paper competition which was attended by 15 coordinators. The development of an ATLS orientation program for new coordinators and review of the current coordinator manual was discussed.

Program for meeting ( See Page 8 )

The 6 papers presented were of a high standard and well received. The winner of resident paper competition was awarded by the selection panel to: Dr Nikhil Agrawal, Australia for his paper ‘The role of serial imaging in non-operative management of blunt splenic injuries” The judging panel comprised Sharon Henry,( ATLS representative ) Prof Kamran Khalid ( Chair, ATLS Pakistan) and Malaysian ATLS Chair, Professor SK Lum. Congratulations to Dr Nikhil Agrawal, who will attend the March CoT Meeting in San Diego in 2016 to present his paper.

Dr Nikhil Agrawal, Perth, Australia

Deb presented two topics to the group :

1) Initial Assessment – making it authentic for the learner. This was a combination of a demonstration and interactive session involving input from all the group. This session was well received and highlighted that some countries expectations of the participants are much stricter than others !!!!

Andre Das showcasing his acting ability !

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2) Evaluating your Teaching - This session challenged the faculty to focus on their current teaching and the importance of evaluation as a vehicle for change in teaching practice.

It was noted that the educator had to work hard to get engagement. This was largely due

to language difficulties and cultural differences. However participants did respond and

there was good discussion generated. Interactive sessions are recommended for the next

meeting as there is a great deal participants can learn from each other.

Dr Gilberto Leung,( Hong Kong) proposed successor to Dr Michael Hollands to take on the

ATLS Chair, Region XV1 has developed a draft of a Region XV1 web-site platform. ( See

link) http://www.atlsregionxvi.org/draft/

Scott showcased the website to the group requesting feedback from the group.

Comments shared included :

1. ? who will be able to access web-site : private v’s public. Will need to develop privacy policy

2. Ensure website is linked to current ACS ATLS web-site so information can be filtered on a two –way basis.

3. Will include ATLS rules/ policies specific to Region XV1. 4. A platform to communicate new ATLS information/ conferences/ workshops. 5. Useful tool for the organisation of future Region XV1 meetings eg Assist in

registration process 6. ? Include section “ FAQ” / blog 7. Platform to advertise “ calendar of events” for individual countries 8. ???? question asked …..who will be maintaining this web-site ? Will the responsibility

be deferred to the country of the current ATLS Region XV1 Chair.

Dr Leung has requested that all members (Faculty, Educators and Coordinators ) please

take time to review web-site and forward comments directly to him by September 30th.

E-mail : gilberto@hkucc.hku.hk

Summary : ATLS Update

All content addition or deletion must be evidenced based Chapter leads and working groups have been assigned and face to face /

teleconferences have commenced to review chapters Educators will have input once content is established All chapters will include summary boxes highlighting the following areas :

Team Management Special population ( obese, elderly, paediatric &

pregnant woman) Rural / limited resources settings

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Chapters will include a clinical scenario : Carry the evaluation & management throughout the chapter Ask & answer questions regarding patient Same scenarios will be re-iterated in M-Learning platform

Time Line for release Feb- June 2016 : Program modules complete

ACS testing and review of alpha version July – Sept 2016 : Beta Testing

Incorporate revisions Modules finalized Final product

October 2016 : Soft launch

March 2017 : release of 10th edition

Initial assessment

Combine sections on assessment & resuscitation Will reflect content changes from all chapters

Airway Focus on evaluation / recognition of airway compromise Re-introduce cricoid pressure

Shock Stress haemorrhage control rather than aggressive crystalloid administration Recommend small 18gIV cannula

Thoracic Remove pulmonary contusion & flail chest from immediate life threatening

category to potential life threatening

Abdominal / Pelvis More emphasis on when to transfer patient when bleeding suspected. Revision of pelvic # management to include early placement of pelvic binder.

Spine

Include NEXUS & Canadian criteria for a c-spine evaluation Removal of long board

Course Schedule : Decrease time for lectures Increase time for skill stations Skills based on scenarios & incorporate skills performance as indicated by

scenario Skills collapsed into 4 90 minute sessions : Airway, Breathing, Circulation

and Disability Multi-media utilization Combine radiology interpretation to single session that can be customized to

local needs

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My ATLS Mobile application

What has happened

o 201102012 – offer app for free with the book purchase, or pay for app. Included “ just in time “ videos and interactive content.

o 2013 – updated resolution to be compatible with 4 inch devices, updated interface, content corrections, push notifications and analytics engine

o 2014 – iBook, eBook, Kindle. MyATLS Impact

o Feedback very positive o 70603 registered users o 141908 downloads o Viewed in 175 countries o Top 5 countries – United States, Indonesia, UK, Mexico & Brazil o Section Analysis :

Just in time videos – most used in 2014 – 21,834 views in February 2015

Least used is skill stations IA viewed most on iOS devices, & airway management

on Android Shock most viewed Most popular adjunct : GCS & Parkland formula

In remembrance of our ATLS colleague, Professor VJ the Singapore team presented

an emotional presentation capturing VJ’s many achievements .

Those who knew him talk of his thoughtfulness, his diplomacy, and the support and

guidance he offered to those around him, no matter the level of stress he may have

been under in his own work. He was a mentor to many.

VJ’s smile will remain bright in the minds of all those who worked with him, who

remember it as an outward expression of his humour and his generous heart.

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Narain shared the experiences of the ASSET course introduced into Thailand in July 2013.

There are now 4 centres in Thailand which have conducted 9 courses since 2013.

Each region presented an overview of ATLS in their region touching on

* Historical trends and statistics

* Challenges of the 9th edition roll-out

* Comments on current ATLS Educational materials

* Innovative inclusions into local provider and instructor courses

* Suggestions for 10th Edition future planning

Notes from Region reports

- Present Lecture content too extensive: ? decrease number of slides and increase time allocated for

lectures

- Initial assessment lecture divided into two components : Primary survey delivered on first day,

secondary survey covered on 2nd day

- Manuals – permission for local printing to decrease costs

- Include formal lecture on Disaster management – provide virtual scenarios

- ? option to replace Post remedial MCQ with OSCE

- 9th edition : Lack of clarification on teaching of Pericardiocentesis . Faculty wishing to remove

“ penetrating IA scenarios” eg Patient I & L as this procedure not formally demonstrated / taught.

- Poor quality / mis- match of x-rays in skill stations and IA scenarios

- Taiwan - ? include nurse practitioner in provider courses. This is possible in USA.

- Process to manage Participants who participate in overseas ATLS courses ( Medical tourism) and

fail MCQ paper eg Australians travelling to Singapore. Which country takes on the responsibility of

following up ?

- Impact of competing trauma courses. ? Expansion of Marketing strategies of ATLS courses

- Financial long term impact of the introduction of Trauma Man being donated by PETA into some

countries

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- Interactive / role playing session demonstrating the triage scenarios in real time presented by

Pakistan

Location : San Diego

Date : March 2016 . Dates to be confirmed

Please note : There will be a Region XV1 Business meeting. A reminder will be distributed

requesting agenda items to ensure future planning of Region XV1 and strategies to maintain

sustainability and moving forward.

Proposed Agenda Items to be tabled from this meeting include:

Medical Tourism – development of policy to manage participants who fail their MCQ when enrolled on an overseas course

Instructor course training - develop policy to manage participants who enroll in overseas instructor courses and the ongoing responsibility of follow up as instructor candidate

The dates and location for the 2016 meeting will be confirmed following discussion with both

Dr Michael Hollands and Dr Gilberto Leung.

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Agenda

Time Activity Presenter

0800 Convene

0815 Welcome and Introductions Michael Hollands

0830-0945 Asia Pacific Free papers competition

Indonesia Dr M. Ayudika

Thailand Dr Poj Lapasampanno

Australasia Dr Nikhil Agrawal

Taiwan Dr Lung-Wei Kuo

Indonesia Dr Arya Rasi Putranto

Singapore Dr Felicia Chua

Chair : Michael Hollands

0830 - 0945 Coordinator break out session ( conjoint session with

Paper competition )

Revision of the ATLS Coordinator Manual/ orientation

program for new coordinators

Chair : Lesley Dunstall

0945-1015 Break

1015-1100 Initial Assessment- making it authentic for the learner Deb Paltridge

1100-1115 Region XV1 is moving forward ! What lies in the future ? Scott D’Amours for Gilberto Leung

1115-1145 ATLS will take on a new look for the10th Edition . An update

will be revealed for the M-learning platform , chapter updates

and skill station changes

Sharon Henry

Karen Brasel

1145-1200 Sharing experiences in Advanced Surgical Skills for exposure

in Trauma (ASSET)

Narain Chotirosniramit

1200-1215 Memorial to Professor VJ Appassamy Singapore

1215-1300 Lunch

1300-1345 Evaluating your teaching Deb Paltridge

1345-1430

Plenary Asia Pacific ( Region XV1) ATLS regional reports

Pakistan

Taiwan

India

Indonesia

Malaysia

Phillipines

Singapore

Thailand

Australasia

Mongolia

Chair: Michael Hollands

1430-1445 Break

1445-1545 Questions from the floor and discussion Panel : Karen Brasel, Sharon Henry,

Monique Drago,Lesley Dunstall

1545 2016 meeting dates and location Michael Hollands

1555 Summary of the day and close Michael Hollands

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1.Did the meeting fulfil your reason for attending ?

o Yes- Absolutely 20

o Yes- But not to my full extent 5

o No

Comment : 1. Very interesting meeting

2. Networking and update

3. Excellent learning experience and opportunity to meet others in the ATLS

family

2. How did you hear or learn about this meeting ?

o Flyer 1

o E-mail 17

o Word of mouth 5

o Referral

o Other 2 1. Came as country representative

3. Please specify the main reason for attending this meeting:

o Content 3

o Networking 9

o Personal growth & development 9

o Speakers 3

o Other 1 1. To learn the skills to improve ATLS course

4. What was the most beneficial or successful aspect of the meeting ?

Comment: 1. Informed about activities of other ATLS centres

2. Meet others from other countries

3. Informed about all the variations of ATLS in different countries to meet their local needs

4. Meeting up and re-establishing friendships amongst the Region XV1 countries

5. All the countries getting together and sharing their experiences

6. Useful for improving ATLS program

7. Session on Initial assessment teaching

8. Educational sessions delivered by D. Paltridge

9. Opportunity to share ideas and problems within the Region

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10. Gain more knowledge regarding latest information on ATLS

11. Exchange of ideas with other coordinators within the region

12. ATLS 10th Edition update

13. Maintaining the network within the Region

14. Research paper presentations

15. Discussion about 10th edition

16. Discussion re problems identified with the 9th edition and to clarify ambiguities regarding course.

17. Update on new practice techniques to manage trauma

18. Demonstration of the Initial assessment

5. What do you think could be improved ?

Comment: 1. Addressing the issues and queries

2. Issue / Rule – canvas everybody’s opinion before voting on Change

3. More time allocated to problems presented at meeting

4. More time allocated to Q & A for the Resident paper section.

5. Feedback given to presenters

6. Instructor & coordinator relationship

7. ACS listen to comments from other countries esp from developing countries so

the ATLS course can be modified and serve patients around the world better

8. ATLS course should be simple course rather than an advanced one using basic

equipment that would be helpful in the management of the majority of the trauma patients

6. Do you have a suggested meeting format / topic or presenter that you would like to

see included in future meetings ?

Comment: 1. Educational input is a gentle reminder on best way to teach ATLS eg How to

Teach. More from D. Paltridge

2. Recent advancements in Trauma

3. Coordinator input – improvements they have developed for their country

4. Time allocated to discuss issues presented by individual countries

5. Best and worse case – is it adaptable with ATLS system ?

7. Would you recommend this meeting to others ?

Comment: 1. Yes, Informative meeting + + + + + +

2. Excellent opportunity for coordinators, educators and instructors to share

ideas

3. Excellent opportunity for Trainees to present research study

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Thank you for your time for helping us shape future meetings to your needs.

Please complete this form and hand in at the end of the meeting or feel free to e-

mail your comments to : Lesley.dunstall@surgeons.org