RESUMEN
The American College of Surgeons Committee on Trauma's Advanced Trauma Life Support Course is currently taught in 50 countries. The 8th edition has been revised following broad input by the International ATLS subcommittee. Graded levels of evidence were used to evaluate and approve changes to the course content. New materials related to principles of disaster management have been added. ATLS is a common language teaching one safe way of initial trauma assessment and management.
Asunto(s)
Curriculum/normas , Educación Médica Continua , Cuidados para Prolongación de la Vida/normas , Traumatología/educación , Heridas y Lesiones/terapia , Competencia Clínica , Curriculum/tendencias , Medicina de Emergencia/educación , Tratamiento de Urgencia/normas , Tratamiento de Urgencia/tendencias , Femenino , Predicción , Humanos , Cuidados para Prolongación de la Vida/tendencias , Masculino , Resucitación/educación , Sensibilidad y Especificidad , Traumatología/tendencias , Estados UnidosRESUMEN
BACKGROUND: In 2007, the American College of Surgeons (ACS) Committee on Trauma implemented a requirement that Level I trauma centers must have a mechanism to identify patients who are problem drinkers and the capacity to provide an intervention for patients who screen positive. Although the landmark alcohol screening and brief intervention (SBI) mandate is anticipated to impact trauma practice nationwide, a literature review revealed no studies that have systematically documented SBI practice pre-ACS requirement. STUDY DESIGN: Trauma programs at all US Level I trauma centers were contacted and asked to complete a survey about pre-ACS requirement trauma center SBI practice. RESULTS: One hundred forty-eight of 204 (73%) Level I trauma centers responded to the survey. More than 70% of responding centers routinely used laboratory tests (eg, blood alcohol concentration) to screen patients for alcohol and 39% routinely used a screening question or standardized screening instrument. Screen-positive patients received a formal alcohol consult or had an informal alcohol discussion with staff members approximately 25% of the time. CONCLUSIONS: The investigation observed marked variability across Level I centers in the percentage of patients screened and in the nature and extent of intervention delivery in screen-positive patients. In the wake of the ACS Committee on Trauma requirement, future research could systematically implement and evaluate training in the delivery of evidence-based alcohol interventions and training in development of trauma center organizational capacity for sustained delivery of SBI.