Advanced trauma life support program increases emergency room application of trauma resuscitative procedures in a developing country

ABSTRACT

Over a 9-year period (July 1981-December 1985--pre-ATLS period; January 1986-June 1990-post-ATLS period), the hospital charts of 813 trauma patients with ISS > or = 16 were reviewed (n = 413, pre-ATLS and n = 400, post-ATLS) in order to assess the impact of the ATLS program. The freqeuncy of endotracheal intubation (ET), nasogastric tube insertion (NG), intravenous access(i.V.), Foley catheterization of the bladder (Foley) and chest tube insertion (CT) were compared by Pearson Chi-square analysis. Overall, pre-ATLS vs. post-ATLS frequencies ( percent) were 83.5 vs. 65.3 for ET, 97.3 vs 98.0 for i.v., 74.6 vs. 96.3 for Foley, 68.3 vs. 91.3 for NG, and 18.4 vs. 47.0 for CT. In the emergency room these frequencies ( percent) were 26.1 vs. 36.4 for ET, 98.8 vs. 98.7 for i.v., 11.0 vs. 97.1 for Foley 3.2 vs. 95.9 for NG, and 3.9 vs for CT. The differences in the application of these life saving procedures between the pre-ATLS and the post ATLS periods were statistically significant (p < 0.05) except i.v. access, which showed no difference between the pre-ATLS and post-ATLS groups. Of the patientys with severe chest injuries (AIS > or = 3) 87.7 percent and chest tubes post ATLS (94.4 percent in ER) compared with 48>1 percent pre ATLS (3.2 percent in ER). These differences were associated with significant improvement in trauma patient outcome post ATLS. We conclude that the frequency of lifesaving interventions, particularly in the ER, was increased post ATLS (AU Truncated at 250 words)