Dr Matt Wiles Sheffield Teaching Hospitals NHS Trust ... · Manual in-line stabilisation [Br J...
Transcript of Dr Matt Wiles Sheffield Teaching Hospitals NHS Trust ... · Manual in-line stabilisation [Br J...
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Dr Matt Wiles Sheffield Teaching Hospitals NHS Trust
@STHJournalClub http://sthjournalclub.wordpress.com
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To examine how the Advance Trauma Life Support (ATLS) course meets the challenges of modern trauma management, with a focus on:
The background to the development of ATLS
The impact of ATLS training on trauma related morbidity & mortality
The weaknesses of ATLS, especially in the context of UK trauma management
To look at how training in trauma management in the UK could be developed in the future
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"When I can provide better care in the field with limited resources than my children and I received at the primary facility, there is something wrong with the system and the system has to be changed.“
James K. Styner
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“With great power comes great responsibility....”
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“So let it be written, so let it be done..”
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“False principles or rules handed down through generations of medical providers and accepted without serious challenge or investigation”
Dr Chris Nickson (@precordialthump)
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Rapid Sequence Induction
[Can J Anesth 2007; 54: 748-764]
Manual in-line stabilisation
[Br J Anaesth 2000; 84: 705-709]
Trauma nasopharyngeal airways
[Emerg Med J 2005; 22: 394-396]
Permissive hypotension
[Anaes 2013; 68: 445-452]
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GCS as a trigger for intubation
[Trauma 2003; 54: 671-680]
[Emerg Med J 2007; 24: 139-141]
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Guly et al. Resuscitation 2011; 82: 556-559
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Mutschler et al. Resuscitation 2013; 84: 309-313
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Demetriades et al. J Am Coll Surgeons 2005; 201: 343-348
De Knegt et al. Injury 2008; 39: 993-1000
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“Rules are for the obedience of fools and the guidance of wise men”
Douglas Bader
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Sequential assessment Permissive hypotension Haemostatic resuscitation Etomidate Importance of CT
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Advanced Trauma Life Support program increases emergency room application of trauma resuscitative procedures in a developing country. Ali et al. Trauma 1994; 36: 391-394
Trauma outcome improves following the Advanced Trauma Life Support Program in a developing country. Ali et al. Trauma 1993; 34: 890-899
Clinical Impact of Advanced Trauma Life Support. Van Olden et al. Am J Emerg Med 2004; 22: 522-525
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“If I had an hour to solve a problem I'd spend 55 minutes thinking about the problem and 5 minutes thinking about solutions.”
Albert Einstein
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“Everything is awesome. Everything is cool when you’re part of a team”
President Business
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[Trauma Team Performance. Barach & Weimger; http://www.academia.edu/5270549/ITTACS_Team_Performance]
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[Capella et al. J Surg 2010; 67: 439-443]
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[Capella et al. J Surg 2010; 67: 439-443]
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28 hospitals, 2860 trauma team members 1 day course
[Wisborg et al. Educ Health 2006; 19: 85-95]
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Treat ATLS as BTLS Stop routine recertification Focus on non-technical skills Institution specific training
Protocols
Team working
Debriefs