Impact of ATLS training on preventable and potentially preventable deaths.
BACKGROUND
Multiple trauma continues to have a high incidence worldwide. Trauma is the leading cause of death among people between the ages of 10 and 40. The Advanced Trauma Life Support (ATLS) is the most widely accepted method for the initial control and treatment of multiple trauma patients. It is based on the following hypothesis: The application of the ATLS program may reduce preventable or potentially preventable deaths in trauma patients.


METHODS
The present article reports a retrospective study based on the records of prospectively evaluated trauma patients between January 2007 and December 2012. Trauma patients over the age of 18 admitted to the critical care unit or patients who died before hospital admission were included. A multidisciplinary committee looked for errors in the management of each patient and classified deaths into preventable, potentially preventable, or nonpreventable. We recorded the number of specialists at our center who had received training in the ATLS program.


RESULTS
A total of 898 trauma patients were registered. The mean injury severity score was 21 (SD 15), and the mortality rate was 10.7 % (96 cases). There were 14 cases (14.6 %) of preventable or potentially preventable death. The main errors were delay in initiating suitable treatment and performing a computed tomography scan in cases of hemodynamic instability, followed by initiation of incorrect treatment or omission of an essential procedure. As the number of ATLS-trained professionals increases, the rates of potentially preventable or preventable death fall.


CONCLUSIONS
Well-founded protocols such as the ATLS can help provide the preparation health professionals need. In our hospital environment, ATLS training has helped to reduce preventable or potentially preventable mortality among trauma patients.
Department of General Surgery, Hospital Universitari Parc Taulí, Sabadell, Spain.
Salvador
S
Navarro
Sandra
S
Montmany
Pere
P
Rebasa
Carme
C
Colilles
Anna
A
Pallisera
D000328:Adult; D061906:Advanced Trauma Life Support Care / Q000592:standards*; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D002568:Certification; D004501:Education, Medical; D005260:Female; D006439:Hemodynamics; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D008297:Male; D019300:Medical Errors; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications / Q000401:mortality / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care; D012189:Retrospective Studies; D012769:Shock / Q000209:etiology / Q000401:mortality*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000401:mortality / Q000628:therapy*; D055815:Young Adult