The European Trauma Course (ETC) and the team approach: Past, present and future

Lott, Carsten; Araújo, Rui Esteves; Cassar, Maria; Bartolomeo, Stefano Di; Driscoll, Peter; Esposito, Ivan; Gomes, Ernestina; Goode, Peter; Gwinnutt, Carl; Huepfl, Michael; Lippert, Freddy; Robinson, D.; Roeßler, Markus; Davis, Mike; Thies, Karl‐Christian

doi:10.1016/j.resuscitation.2009.06.023

Cited by 40 publications

(16 citation statements)

References 20 publications

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“…However, this does not mean that patients who have injuries that are obviously not compatible with any chance of survival should undergo any resuscitation attempts. In this respect, trauma management programs that contains a more liberal algorithm supporting resuscitation attempts [21] should be encouraged.…”

Section: Discussionmentioning

confidence: 99%

Cardiopulmonary resuscitation traumatic cardiac arrest - there are survivors. An analysis of two national emergency registries

et al. 2011

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IntroductionCardiac arrest following trauma occurs infrequently compared with cardiac aetiology. Within the German Resuscitation Registry a traumatic cause is documented in about 3% of cardiac arrest patients. Regarding the national Trauma Registry, only a few of these trauma patients with cardiac arrest survive. The aim of the present study was to analyze the outcome of cardiopulmonary resuscitation (CPR) after traumatic cardiac arrest by combining data from two different large national registries in Germany.MethodsThis study includes 368 trauma patients (2.8%) out of 13,329 cardiac arrest patients registered within the Resuscitation Registry, whereby 3,673 patients with a cardiac cause and successful CPR served as a cardiac control group. We further analyzed a second group of 1,535 trauma patients with cardiac arrest and early CPR registered within the Trauma Registry, whereby a total of 25,366 trauma patients without any CPR attempts served as a trauma control group. The relative frequencies from each database were used to calculate relative percentages for patients with traumatic cardiac arrest in whom resuscitation was attempted.ResultsWithin the Resuscitation Registry, cardiac arrest was present in 331 patients (89.9%) when the EMS personal arrived at the scene and in 37 patients (10.1%) when cardiac arrest occurred after arrival. Spontaneous circulation could be achieved in 107 patients (29.1%). A total of 101 (27.4%) were transferred to hospital, 95 of whom (25.8%) had return of spontaneous circulation (ROSC) on admission. According to the Trauma Registry, the overall hospital mortality rate for cardiac arrest patients following trauma was 73% (n = 593 of 814). About half of the patients who were admitted alive to hospital died within 24 hours, resulting in 13% survivors within 24 hours. 7% of the patients survived until hospital discharge, and only 2% of the patients had good neurological outcome.ConclusionsOur present study encourages CPR attempts in cardiac arrest patients following severe trauma. When a manageable number of patients is present, the decision on whether to start CPR or not should be done liberally, using comparable criteria as in patients with cardiac etiology. In this respect, trauma management programs that restrict CPR attempts should not be encouraged.

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Section: Discussionmentioning

confidence: 99%

Cardiopulmonary resuscitation traumatic cardiac arrest - there are survivors. An analysis of two national emergency registries

et al. 2011

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“…In conclusion, the time for cricothyrotomy in the present study is comparable with that of other studies as long as similar settings and definitions were used. However, it became obvious that in clinical settings, DAM and cricothyrotomy in particular should be performed by a trained and determined physician 19–22. However, simulation remains the only method to train and evaluate such aspects of DAM.…”

Section: Discussionmentioning

confidence: 99%

Impact of cardiopulmonary resuscitation on a cannot intubate, cannot oxygenate condition: a randomised crossover simulation research study of the interaction between two algorithms

et al. 2019

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ObjectivesDuring a ‘cannot intubate, cannot oxygenate’ situation, asphyxia can lead to cardiac arrest. In this stressful situation, two complex algorithms facilitate decision-making to save a patient’s life: difficult airway management and cardiopulmonary resuscitation. However, the extent to which competition between the two algorithms causes conflicts in the execution of pivotal treatment remains unknown. Due to the rare incidence of this situation and the very low feasibility of such an evaluation in clinical reality, we decided to perform a randomised crossover simulation research study. We propose that even experienced healthcare providers delay cricothyrotomy, a lifesaving approach, due to concurrent cardiopulmonary resuscitation in a ‘cannot intubate, cannot oxygenate’ situation.DesignDue to the rare incidence and dynamics of such a situation, we conducted a randomised crossover simulation research study.SettingWe collected data in our institutional simulation centre between November 2016 and November 2017.ParticipantsWe included 40 experienced staff anaesthesiologists at our tertiary university hospital centre.InterventionThe participants treated two simulated patients, both requiring cricothyrotomy: one patient required cardiopulmonary resuscitation due to asphyxia, and one patient did not require cardiopulmonary resuscitation. Cardiopulmonary resuscitation was the intervention. Participants were evaluated by video records.Primary outcome measuresThe difference in ‘time to ventilation through cricothyrotomy’ between the two situations was the primary outcome measure.ResultsThe results of 40 participants were analysed. No carry-over effects were detected in the crossover design. During cardiopulmonary resuscitation, the median time to ventilation was 22 s (IQR 3–40.5) longer than that without cardiopulmonary resuscitation (p=0.028), including the decision-making time.ConclusionCricothyrotomy, which is the most crucial treatment for cardiac arrest in a ‘cannot intubate, cannot oxygenate’ situation, was delayed by concurrent cardiopulmonary resuscitation. If cardiopulmonary resuscitation delays cricothyrotomy, it should be interrupted to first focus on cricothyrotomy.

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“…Although it has its critics, 6,7 the Advanced Trauma Life Support Course (ATLS Õ ) 8 provides an introduction to the management of complex trauma for junior trainees who will form part of the trauma team. 9 The European Trauma Course 10,11 expands on knowledge from ATLS Õ and allows the opportunity to practice as a small trauma team and perform in the role of the trauma team leader. This article documents the training programme using fully immersive simulation that has been developed at Aintree University Hospital NHS Foundation Trust in Liverpool in collaboration with the regional simulation centre, in order to meet the obligations as part of the peer review process 12 and develop the trauma team.…”

Section: Introductionmentioning

confidence: 99%

Using full immersive simulation to prepare trauma teams to work in a major trauma centre

Mercer

2016

Trauma

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A reconfiguration of trauma services in the UK has led to the development of trauma networks with major trauma centres. This article describes the use of fully immersive simulation to train whole trauma teams in both a traditional simulation centre setting and 'in situ' in the clinical environment. Carefully designed scenarios that are driven by experienced faculty allow modern trauma management concepts, such as damage control resuscitation and massive transfusion to be explored within a hospital's own organisational structure. Human factors specific to the trauma team can also be explored as part of a video-assisted debrief.

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The European Trauma Course (ETC) and the team approach: Past, present and future

Cited by 40 publications

References 20 publications

Cardiopulmonary resuscitation traumatic cardiac arrest - there are survivors. An analysis of two national emergency registries

Cardiopulmonary resuscitation traumatic cardiac arrest - there are survivors. An analysis of two national emergency registries

Impact of cardiopulmonary resuscitation on a cannot intubate, cannot oxygenate condition: a randomised crossover simulation research study of the interaction between two algorithms

Using full immersive simulation to prepare trauma teams to work in a major trauma centre

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