Notes on Trauma

Welcome to "Notes on Trauma." This will be a place for you to look for trauma news from all over the world every month. As an introduction, I wanted to share with you what I'll be writing about and how you can interact with this column to bring information useful to your practice:

  • Science: Research and scientific evidence that will impact outcomes will be discussed here. Whether it is positive or negative, I'll review current literature and published studies and tell you how you can use the information to benefit your patients.
  • Education and Training: I will tell you about trauma training advances in North America and across the globe, and introduce you to training opportunities and the people who share your passion about prehospital trauma care.
  • Legislation: For our U.S. readers, I'll talk about trauma-related legislation and guide you to opportunities to support laws that support trauma care. As for those of you outside of the U.S., I'll be happy to post information about legislative activity in your countries as well.
  • Your impact: The third area I'd like to address is in regard to your questions and concerns. Whatever you want to talk about, I'll be happy to discuss it here.

To get started, I had the opportunity to work with doctors, nurses and technicians in India and South America in 2009, and I'd like to share with you what's been happening in trauma care there.

Trauma Training in India

With 1.2 billion people, medical care of any kind in India can be a challenge, but this huge population also presents challenges to professionals interested in the care of trauma patients. With trauma centers designated, professionals in India are beginning to look at building systems and training providers to provide organized trauma care for India.

In April 2009, the first ATLS courses were conducted at AIMS hospital in New Delhi. This came about through the efforts of Professor Mahesh Misra of the AIMS Institute who put together an organization that will support ATLS training and its further spread throughout India.

Once the organization was approved by the ATLS subcommittee, the process continued with initial training that was conducted in Fajirah, United Arab Emirates, with the assistance of the UAE medical director Dr. Subash Gautam. Plans were then laid for the inaugural courses to be conducted in New Delhi.

The International team that assisted with the inaugural courses in India was led by Dr. Christoph Kaufmann of Portland, OR, the ATLS International Director. The rest of the team included Dr. John Kortbeek, ATLS subcommittee chair from Calgary, Canada, and Dr. Jameel Ali of Toronto, Canada. Dr. Michael Hollands, the ACS Committee on Trauma Chief for Region 16, and Dr. Subash Gautam of UAE, completed the faculty. I was on hand as the ATLS program manager for the American College of Surgeons and worked with the coordinator candidates on monitoring their work on the first Indian courses.

The Indian health ministry is lending its support to trauma care and is working to assist AIMS in opening more sites throughout India. They would like to see 10,000 doctors a year trained in ATLS within two years. In looking at the ATLS India website, you'll see that they have already identified over 20 potential ATLS course sites.

The need for trauma training and systems planning is clear. In the large cities, congested traffic creates large numbers of injured patients. Getting to the patients and then transporting them to hospital is challenging. The government is buying ambulances and looking to increase prehospital training as well. They hope to bring PHTLS on board within the next year.

Trauma Training in South America

South American PHTLS faculty participated in a PHTLS 6th editon update course in Santa Cruz, Bolivia, in May 2009. Hosted by Dr. Gonzalo Ostri, the national director for PHTLS Bolivia, the update was attended by the Bolvian PHTLS faculty, as well as Dr. Froilan Fernandez, the national director for PHTLS in Chile and Dr. Luis Eduardo Ruiz Vald├ęs for the Panamanian PHTLS faculty. At the invitation of Dr. Ostria, I conducted the update course and stayed on to observe the Bolivian faculty conducting a provider course. The Bolivian faculty also provides ATLS training and their strong faculty continues to provide trauma training for Bolivia.

Latin America Trauma Specialists Come Together

I was able to participate once again in the PanAmerican Trauma Congress held last year in Cracas, Venezuela. Sessions were offered covering trauma issues, disaster response and EMS. While this meeting focuses on the role of surgeons in trauma care, Dr. Oswaldo Rois with Foundation EMME in Argentina is planning the first Latin America PHTLS congress to bring all of the Latin American faculty together to discuss trauma issues and promulgation of prehospital trauma training throughout Latin America. Plans are underway for an April 2010 meeting. Likewise, PHTLS faculty in Europe are putting together the first European PHTLS meeting, which will be held in February 2010.

I'm very happy to be part of the team and look forward to our monthly meetings here.

Will Chapleau, EMT-P, RN, TNS, is Advanced Trauma Life Support program manager for the American College of Surgeons, Chair of Prehospital Trauma Life Support for the National Association of Emergency Medical Technicians, and a member of EMS Magazine's editorial advisory board.