RELEVANT EDUCATION IN VISCERAL TRAUMA
As mentioned in the Introduction, surgeons and surgical education in Europe is challenged by predominantly blunt trauma increasingly managed non-operatively, work hour restrictions, and few well developed trauma systems centralizing the most severely injured to well defined and dedicated trauma centres, most surgeons will feel uncomfortable with critically ill trauma patients. Let’s face it, the surgical responsibility for the critically injured trauma patient from the acute phase in the ED through hospital definitive treatment and ICU stay is not adequately covered in our surgical education. Every surgeon is responsible for his/her own competency in this field. With this chapter, the VTS seeks to point out what educational elements are necessary to reach a minimum competency in trauma care, and then provide a list of courses available within each of these areas. The VTS is not aiming at devloping new course concepts where there are relevant, high quality courses available. However, the VTS is open to taking on the challenge of developing educational concepts where deemed necessary.
The four main areas every surgeon should have additional education in order to be able to function in a team or as a trauma team leader and trauma surgeon are:
- BASIC INDIVIDUAL TRAUMA SKILLS
- Advanced Trauma Life Support – ATLS (link website ATLS Europe)
Similar courses for nursing staff like ATCN and TNCC should be promoted
- European Trauma Course – ETC (link)
Based on the same ABCDE principles as ATLS but has the teamwork aspect added (CRM)
- Several local versions exist – they should only be regarded as additions to ATLS/ETC
- COMMUNICATION – non-technical skills (Crew Resource Management – CRM)
- ETC – has the team communication aspect as part of the curriculum
- Many local trauma team communication simulations exist and all hospitals should be training team communication regularly.
- Advanced trauma surgical technical skills
- Definitive Surgical Trauma Course – DSTC (owned by IATSIC within ISS …link)
DSTC is a 3 day course with practical training as well as interactive discussions and robust training in surgical decision-making based on physiology. DSTC is currently organized in 29 countries; in Europe: France, Italy, Portugal, Greece, Netherlands, Denmark, Sweden, Norway, Germany, Austria.. In several countries the course is being organized as a team course with anaesthesia (DATC)
- Advanced Surgical Skills ..trauma – ASSET
One day didactic course owned by the ACS. Trains mainly vascular access in cadavers, but with some focus on decision-making. We suggest it as an add-on to DSTC or equivalent.
- Advanced Trauma Operative Management – ATOM
One-day course focusing on trauma surgical technical skills. We suggest it to be used as refresher course after DSTC or combined with decision-making training.
- Other specific trauma relevant courses