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Pediatricians and the Advanced Trauma Life Support (ATLS): time for reconsideration?
R Ben-Abraham1, A A Weinbroum, Y Kluger
1Department of Anesthesia and Critical Care Medicine, Tel Aviv Sourasky Medical Center, Tel-Hashomer, Israel.
Insights
Pediatricians find Advanced Trauma Life Support (ATLS) courses highly valuable for improving pediatric trauma care. A specialized ATLS course for pediatricians is recommended to enhance emergency care standards for children.
Area of Science:
- Emergency Medicine
- Pediatric Care
- Medical Education
Background:
- General pediatricians in Israel manage pediatric trauma but lack specialized training.
- Current Advanced Trauma Life Support (ATLS) courses are insufficient for pediatricians.
- Pediatric trauma care is not integrated into pediatric specialty training in Israel.
Purpose of the Study:
- To evaluate the practical utility of ATLS courses for pediatricians.
- To assess the impact of ATLS training given limited resources.
Main Methods:
- Telephone survey of 115 pediatricians who completed ATLS between 1990-1994.
- A 67% response rate was achieved.
- Survey included questionnaires on life-saving procedures and subjective utility assessment.
Main Results:
- 56% of surveyed pediatricians routinely treated both adult and pediatric trauma.
- 81% of those treating pediatric trauma performed ATLS procedures.
- Pediatricians ranked ATLS courses as having a "very high" to "high" impact on their practice.
Conclusions:
- A pediatric-specific ATLS course can significantly improve pediatric trauma care.
- Mandatory ATLS training for pediatric residents is recommended for standardized care.
- Further research is needed to objectively measure the impact of ATLS on pediatric trauma outcomes.
Background:
General pediatricians in Israel are actively involved in the initial evaluation, resuscitation and management of traumatized children. However, pediatric trauma care is not a part of pediatric specialty training in Israel, and the few Advanced Trauma Life Support courses per year are insufficient for most pediatricians working in accident and emergency care.
Objective:
To examine the value of the course in relation to the limited resources available for such training.
Methods:
A telephone survey of 115 pediatricians who had taken the course between 1990 and 1994 was conducted. The responding physicians (67%) were asked to complete a specially designed questionnaire on life-saving procedures that were taught in the course. In addition, they were asked to subjectively assess the practical utility of the course.
Results:
Forty-three (56%) pediatricians reported that they routinely treated both adult and pediatric trauma cases. Of these, 81% performed 27 life-saving ATLS procedures. Pediatric trauma was treated by only 22 (28%), of whom 72.3% performed 18 life-saving ATLS procedures. These pediatricians ranked the courses as being "very high" to "high" in impact.
Conclusions:
These figures indicate that an ATLS course designed specifically for pediatricians can markedly improve pediatric trauma care. To ensure standard education and patient care, such a course should be developed and made a mandatory component of residency training. Further studies to examine the objective impact of the courses on pediatric trauma care should be carried out.