[Prehospital trauma care training course. Integration of emergency physician and rescue services].
BACKGROUND
With the emergence of a trauma network in the metropolitan area of Nuremberg, Germany, the question arose whether prehospital trauma management and emergency department management could be better integrated. A training scheme was designed for prehospital trauma care by the rescue services of the Workers' Samaritan Federation Germany (ASB), the Bavarian Red Cross, Maltese Ambulance, St. Johns Ambulance, representatives of the emergency physicians, and physicians of Rummelsberg Hospital.


METHODS
A detailed search of the international literature was done for all subjects regarding prehospital trauma management, and the American training systems (ITLS, PHTLS) were studied. The review was followed by a critical evaluation of the reality of on site-care, and the German and American systems were compared.


RESULTS
A 2-day course with 6 sessions (accident place and kinetics, trauma investigation, pathologies, resuscitation, practical training, and evaluation) was developed, adapted from the Advanced Trauma Life Support (ATLS) algorithm. Special attention was given to the integration and position of the emergency physician in Germany, as well as to the defined authority of the rescue services.


CONCLUSIONS
Conversion into practice was facilitated by teamwork. The course is free of charge to all rescue services and members of the concept group. With a qualified prehospital system that works smoothly with the ATLS concepts, improved prehospital care for trauma patients seems possible.
Kopschina
C
C
Abteilung für Unfallchirurgie, Orthopädisch Unfallchirurgische Klinik Wichernhaus, Krankenhaus Rummelsberg, Schwarzenbruck. carsten.kopschina@klinikum-nuernberg.de
Stangl
R
R
D019033:Delivery of Health Care, Integrated / Q000379:methods / Q000458:organization & administration*; D004501:Education, Medical / Q000458:organization & administration*; D004632:Emergency Medical Services / Q000458:organization & administration*; D005858:Germany; D006801:Humans; D010820:Physicians; D018635:Rescue Work / Q000458:organization & administration*; D014481:United States; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000628:therapy*