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Saturday, May 29, 2010

Book Review: ATLS Advanced Trauma Life Support for Doctors

ATLS, Advanced Trauma Life Support for Doctors is an excellent resource for physicians who treat trauma patients. The book is written very well, with a list of objectives for each chapter listed at the front. The chapters are also arranged in the same order as the recommended management of the trauma patient; for example, the first chapter deals with the initial trauma patient assessment and management (the ABC'S of trauma). Subsequent chapters address airway/ventilatory management, shock, and then trauma management of various organ systems or regions of the body. As always there are excellent chapters addressing pediatric and geriatric trauma, burns, and trauma in the pregnant woman.

The book also includes several appendices dealing with such sundry items as injury prevention, the biomechanics of injury, and trauma scores. There are also sections of the appendix which deal with disaster management, emergency preparedness and trauma care in austere environments. I do not recall these articles being present in the ATLS course I took during my fellowship back in 1995. This reflects the changes which have happened over the past fifteen years in the world - 9/11, the war in Afghanistan and Iraq, and the continued threat of terrorist attacks which is a new experience for this country. I remarked to the instructors that the lessons learned in combat are evident in the course materials.

ATLS started in the 1970's after a surgeon saw how poorly members of his own family were treated at a small hospital after an aircraft accident. Since then, over one million physicians all over the world have taken the course. My reason for taking it in 1995 was to manage trauma patients while moonlighting as a flight physician - the doctor in the back o f the helicopter. Oftentimes we would fly to the scene of an accident and have to deal with whatever we found on the ground. Having ATLS gave me a systematic way to evaluate and treat a patient in some of the worse conditions I have ever been. Those days are over for me; now I stay at the hospital and deal with the occasional trauma patient. But it is still beneficial for an anesthesiologist to be on the same page as his surgical and emergency room colleagues when it comes to dealing with trauma. I strongly recommend this course to all of my colleagues.

The book includes a DVD which demonstrates some of the techniques for minor surgical procedures and airway management. One of the videos show the WRONG way to evaluate and treat the trauma patient. My wife and I found this very amusing. The course itself did not have the dog lab I recall taking; a trauma simulator has been developed which has replaced vivisection.

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