Atls® International Meeting Minutes October 22-23, 2011 ⦁ San Francisco, ca saturday, October 22, 2011 Welcome – Dr. John Kortbeek Tribute to Dr. Brent Krantz – Dr. Brent Eastman

Revisions for 9^th Edition – Dr. Karen Brasel

1. 
   9^th Edition revisions underway
   
   1. 
      Content, format
      
2. 
   E-version and 9^th Edition to be released in October 2012
   
   1. 
      Shows the new 9^th Edition Student Manual cover
      
3. 
   New Content
   
   1. 
      Table: A brief summary of Wright, et al. Levels of Evidence JBJS(A)
      
   2. 
      Initial Assessment
      
      1. 
         Team training
         
      2. 
         Huddle
         
      3. 
         Checklist
         
      4. 
         Debrief
         
   3. 
      Airway (pediatric)
      
      1. 
         Uncuffed tubes infants (<12 mo.)
         
      2. 
         Cuffed tubes
         
         1. 
            Children
            
         2. 
            Toddlers
            
   4. 
      Circulation
      
      1. 
         Balanced resuscitation
         
         1. 
            Hypotensive
            
         2. 
            Early use of plasma, platelets
            
         3. 
            Until bleeding controlled
            
      2. 
         Angioembolization emphasized
         
      3. 
         Tourniquet
         
      4. 
         No aggressive resuscitation
         
   5. 
      Initial Assessment scenarios
      
      1. 
         At least 8 new scenarios
         
         1. 
            Geriatric focus
            
         2. 
            Pelvic trauma
            
         3. 
            Rib fractures
            
      2. 
         Standard template for current scenarios
         
4. 
   New Format
   
   1. 
      Pelvic trauma
      
   2. 
      Abdominal evaluation
      
   3. 
      Combined shock & surgical skills
      
5. 
   Educators
   
   1. 
      National Educator Group
      
      1. 
         2 reps from North America
         
      2. 
         2 reps from each international region
         
   2. 
      Revise Instructor course
      
      1. 
         Emphasis on assessment, feedback
         
   3. 
      Input on e-course format
      
6. 
   ATLS E-Learning
   
   1. 
      1-Day format
      
   2. 
      2-Day format
      
7. 
   App, mobile website
   
   1. 
      Will include chapter key points, pitfalls, summaries, videos, formulas, and algorithms
      

Educator Update – Dr. Wesam Abuznadah (on behalf of Dr. Bonvin)

1. 
   Major revisions have been made to the feedback/assessment content in the Instructor course.
   
2. 
   Continue to work on the 9^th edition Instructor course and Refresher course.
   
3. 
   Provide guidance on the e-course and other educational activities.
   
4. 
   Senior Educator Advisory Board
   
   1. 
      2 representatives for each Region
      
   2. 
      1 chair – Dr. Bonvin
      

ATLS Middle East & KSA 20^th – Dr. Wa’el Taha

1. 
   Country and trauma statistics are provided.
   
   1. 
      Trauma is leading cause of deaths – 6,000 annually.
      
2. 
   There are many challenges to the system.
   
   1. 
      No hospital or trauma system, lack of cooperation
      
3. 
   ATLS has helped increase the number of trained physicians
   
   1. 
      1991: 0ne center
      
   2. 
      Currently: 20 centers
      
4. 
   ATLS is now a requirement for residents (surgical, emergency med, and family)
   
5. 
   Developed new collaborations with the Ministry of Health to train physicians and nurses.
   

Promulgation Challenges in MENA – Dr. Subash Gautam

1. 
   An overview of the new Region 17 boundary and listing of countries is provided.
   
2. 
   Safety continues to be a concern.
   
3. 
   Country GNP data is provided.
   
4. 
   Many countries cannot afford ATLS. This is our challenge for the future. Cost of surgical practicum is extensive. We need a low-cost option.
   

Educator Perspective in the Middle East – Dr. Wesam Abuznadah

1. 
   Culture and education citations are extensive.
   
2. 
   Dedication in MENA is outstanding.
   

Australian Instructor Course – Dr. Philip Truskett

1. 
   There has been growth in course numbers, faculty, and Coordinators since 2006.
   
2. 
   Philosophy
   
   1. 
      To promote excellence in teaching using:
      

1. 
   Best practice educational methodology
   
   1. 
      Opportunities for practice
      
   2. 
      Feedback
      
   3. 
      Clear assessment criteria
      
2. 
   ATLS content
   
3. 
   Modeled educational practices by Faculty
   
1. 
   Centralized location for all Australasia
   
2. 
   Strong collaboration between Course Director and Educator
   
3. 
   Consistent Faculty – attend entire course (all faculty types)
   
1. 
   Overview
   
   1. 
      2 ½ day course Fri – Sun
      
   2. 
      Pre-course requirement - ATLS content
      
   3. 
      16 participants
      
   4. 
      One course Director, one Educator, one Coordinator and 5 Instructors
      
   5. 
      Always one committee member
      
2. 
   Course Overview, Day 1
   
   1. 
      EMST Icebreaker
      
   2. 
      Lesson Planning/learning objectives
      
   3. 
      Making ATLS interactive
      
   4. 
      Questioning techniques
      
   5. 
      How to give effective feedback
      
   6. 
      Practice Session – teaching
      
3. 
   Course Overview, Day 2
   
   1. 
      Managing the difficult participant
      
   2. 
      Principles of teaching a skill
      
   3. 
      Practice Session – teaching a skill
      
   4. 
      Assessment methodology
      
   5. 
      Assessment – Teaching a skill
      
   6. 
      Practice Initial Assessment station
      
4. 
   Course Overview, Day 3
   
   1. 
      Assessment - Microteaching – assessed by the educator
      
   2. 
      Assessment - Initial Assessment station – assessed by instructors
      
5. 
   Microteaching
   
   1. 
      Given an ATLS topic
      
   2. 
      8 minute presentation that must demonstrate:
      
      1. 
         Set/Body/Closure
         
      2. 
         Time Management
         
      3. 
         Interaction of participants
         
      4. 
         Innovation
         
   3. 
      Instructor Candidates provided with individual feedback (written and verbal) and DVD of performance for subsequent reflection
      
6. 
   Initial Assessment Station
   
   1. 
      Assessed as an Instructor running the Initial Assessment Station:
      
      1. 
         Briefing Patient
         
      2. 
         Briefing Nurse
         
      3. 
         Briefing Candidate
         
      4. 
         Facilitating the scenario
         
      5. 
         Providing Candidate with feedback
         
      6. 
         Assessing the Candidate
         
7. 
   Assessment
   
   1. 
      Clear criteria
      
   2. 
      Individual assessment components and overall course assessment
      
   3. 
      Candidates nominated by experienced Faculty to do the course
      
      1. 
         Not always the right people
         
      2. 
         Candidates do occasionally fail
         

RTTDC Promulgation in India – Dr. Mahesh Misra

India is receiving the heaviest injury in rural areas.

1. 
   Course Design
   
   1. 
      Duration- one day course with 2 distinct sessions
      
   2. 
      Morning session- consists of clinically focused didactic lectures on airway, breathing, circulation, disability, exposure and environment, as well as special considerations such as pregnancy, pediatrics, burns and geriatrics.
      
   3. 
      Afternoon session- covers Performance Improvement and Patient Safety (PIPS) initiatives, followed by interactive small group case-based team scenarios designed to stimulate critical thinking and application of knowledge. 
      
   4. 
      Communication module emphasizing the importance of effective communication between the trauma center and rural center
      
   5. 
      Between Next Appropriate Level Hospital – Able to cater to the needs of the patient
      
   6. 
      Trauma Team Leaders – Made aware of the need to recognize the need for transfer and where to transfer
      
   7. 
      Good communication makes for a good team - works for the benefit of the patient.
      
2. 
   India at a glance
   
   1. 
      In the last 5 years there has been an 8% increase in road deaths.
      
   2. 
      In 2009 over 350,000 people lost their lives in accidental deaths, which is an increase of 31.3%
      
   3. 
      India records the highest number of deaths in RTA in World.
      
      1. 
         14 deaths per hour; these are numbers from 2009.
         
3. 
   India – Most Suited for RTTDC
   
   1. 
      70% to 80% of people in India live in rural areas
      
   2. 
      Trauma care is one of the most common reasons for families going into debt.
      
   3. 
      India is well-suited for the RTTDC program because of the absence of prehospital care in rural areas. This program can improve the chances of patients’ survival.
      
4. 
   Other Courses
   
   1. 
      Promulgated ATLS in 2009
      
      1. 
         4 sites
         
   2. 
      Promulgated ATOM in 2010
      
5. 
   RTTDC in India
   
   1. 
      The Instructor course was held on 4-19-2011
      
   2.