Advanced trauma life support study: quality of diagnostic and therapeutic procedures.
BACKGROUND
The introduction of the ATLS course in The Netherlands in 1995 provided for an opportunity to compare data of trauma patients between a pre-ATLS and a post-ATLS period.


METHODS
Over a 3-year period (May 1996 - September 1997 pre ATLS; December 1997-April 1999 post ATLS) 63 trauma patients with an AIS-ISS > or = 16 (n = 31, pre-ATLS and n = 32, post-ATLS) were prospectively studied in two community residency training (ACS Level III) hospitals. All diagnostic and therapeutic procedures were recorded by a video-camera and evaluated by a neutral faculty of six experienced ATLS trained specialists.


RESULTS
Ten out of 14 interventions were performed qualitatively better in the post-ATLS group, while also the overall score was highly significantly better (4.2 pre-ATLS and 5.8 post-ATLS, p < 0.0001).


CONCLUSIONS
Using the opinion of an expert team, this study identified a significantly lower number of patients with inadequate management.
van Olden
Ger D J
GD
Department of General Surgery, Erasmus Medical Center, Rotterdam, The Netherlands.
Meeuwis
J Dik
JD
Bolhuis
Hugo W
HW
Boxma
Han
H
Goris
R Jan A
RJ
D000328:Adult; D022561:Advanced Cardiac Life Support / Q000193:education / Q000592:standards; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D004503:Education, Medical, Graduate / Q000592:standards; D005180:Faculty, Medical; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D007396:Internship and Residency / Q000592:standards; D008020:Life Support Care / Q000592:standards; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009104:Multiple Trauma / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D009426:Netherlands / Q000453:epidemiology; D015588:Observer Variation; D017063:Outcome Assessment, Health Care; D015397:Program Evaluation; D011446:Prospective Studies; D011787:Quality of Health Care / Q000592:standards*; D016019:Survival Analysis; D014194:Traumatology / Q000193:education / Q000592:standards; D014743:Videotape Recording