Archaic Trauma Life Support

Pond Life

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ATLS: Archaic Trauma Life Support
M. D. Wiles Consultant Neuroanaesthetist. Article first published online: 7 JUL 2015. DOI: 10.1111/anae.13166
http://onlinelibrary.wiley.com/doi/10.1111/anae.13166/full

Someone has at last written what many have been saying for years. ATLS approach is ok for a doc alone in a community hospital but no good for MTC's and doesn't reflect our current approach to trauma care.

I was in an ATACC course back in 2009 and talking about damage control surgery, TXA and so on which had been out for a few years (@2006 in my area). Here we are in 2015 and still ATLS not teaching this stuff which is almost a decade old. They are even still preaching an ABCDE approach and not CACBCDE or MARCH.

So the question is now out there - perhaps now there will be change.
 

Brandon O

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It was always meant to bring up the common denominator, not innovate.
 

Carlos Danger

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Pond Life

Pond Life

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I never said it wasn't - in fact I think that's what I wrote.
But it's globally being sold as the only recognised trauma course for doctors and as such it has an obligation to teach current (past decade) approaches to trauma care.
 

Brandon O

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I hear you, but that's sort of the norm for certification courses. The idea is that everyone should be doing "at least" these standards. Compare with AHA resuscitation guidelines, for instance. Slow, steady, but relatively reliable and widely applicable.

The progressive ideas that cutting-edge centers are individually playing with today will, after Darwinian winnowing (and some politics and random entropy) percolate that way eventually.

Probably in about 10 years, as you say...
 

triemal04

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I never said it wasn't - in fact I think that's what I wrote.
But it's globally being sold as the only recognised trauma course for doctors and as such it has an obligation to teach current (past decade) approaches to trauma care.
<giggle> An obligation? That's funny! The only obligation it has is to make money for itself; they could continue to bill themselves the way they do and start teaching that each and every patient, no matter what, gets an immediate DPL and cutdown as the first step and there wouldn't be anything to stop them. Other than people not going to the classes of course.

It's been said, but it takes awhile before the cookie-cutter classes will catch up to what current trends in treatements are and often they'll always stay several years behind; there's a reason for this. While practitioners in the field/hospital can get away with innovations and trying new things (and depending on what you do to stay current many of the "standard" things you might be thinking of really are still pretty new, or newish, at least in reaching a wide audience) classes like that have to have the data and literature to back those things up, otherwise they run the risk of teaching every idea or fad that comes up, good or crackpot.

It is unfortunate that ATLS has such widespread name recognition and really is being used for more than the intended purpose. If you're ever in Australia the Emergency Trauma Management Course is supposed to be decent.
 

ThadeusJ

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I have seen a few different approaches and the best so far has been the traveling trailer/sim lab that goes from place to place and shows the TEAM how to deal with certain scenarios. This may involve local paramedics as well as the ER team. It uses their own equipment as well. An excellent model but extremely hard to get off the ground.
 
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