ATLS 10 TH EDITION

Introducing the Team Approach

June 2017
 ATLS Meets Trauma Team Training

A match made in heaven or a disaster for all??

Lets see ……
• Course Director
• ATLS Provider
• Trauma Team Leader
• Trauma Team Member
• “When I can provide better care in the field with limited resources than
my children and I received at the primary facility, there is something
wrong with the system and the system has to be changed.”

• “I can describe this experience as coming out of hostile dark hell into
civilisation.”
--Dr James Styner
 ATLS and the Trauma Team

• Why?

• What?

• How?
 Why?

• Well, you have been asking for something …..

• It’s been missing (content and time).

• It’s the direction of travel for most of us.

 Mission Statement
The UK ATLS Steering Group have worked in
collaboration with the American College of
Surgeons Committee on Trauma for 4 years to
create a Trauma Team Training section of the
10th edition of ATLS

(- And we have the scars to prove it!)

Before I go any further..

• This is not meant to dilute the ATLS message.

• This is not a Trauma Team course.
• You need to be able to do it vertically first.
• One safe way.
The threat was loss of…
• The skill to deliver the ATLS system as an
individual sequentially.

• the current method of assessment that an

individual can do that to a standard.

• One safe way.

 The New Core Material
• 10th Edition ATLS manual includes an Appendix
(Chapter) on Trauma Team Resource
Management.
• Each chapter now has a short section on
special situations for the Trauma Team
(chapter additions).
• Trauma Team Video (with all star cast)
• Guidance for an interactive discussion on the
function of the trauma team.
 Snapshot of What’s in the Team
Chapter
• Objectives
• Team Leader Briefing
• Communication
• Conflict Resolution
• Debriefing
 ATLS and Trauma Team Resource
Management - Objectives
• Describe configuration of a trauma team.
• Identify the team leaders roles and responsibilities.
• Discuss the qualities of good leadership.
• List the roles and responsibilities of team members.
• Focus on best communication practices and describe
how to manage conflict.

Was solely written by UK authors.

(..we have the scars etc etc!)
“To function well as part of a team, an individual
must be familiar with all the steps required to
attain the best possible outcome. This appendix
demonstrates how a clinician trained in ATLS
techniques can function with others to deliver
excellent team care with a common goal”
Box E-2 Team Leader Briefing The Trauma Team (i)

• Introduce yourself, ensure all team members know

you are the leader.
• Ask other team members to introduce themselves
and establish their skill levels. Establish the nurse
assistants are familiar with the environment.
• Allocate the role of scribe.
• Ensure Team Members adopt universal precaution.
• Explain the procedure for taking handover
Contd (ii)

• Ensure Team Members know how to communicate

important positive and negative findings directly to
the Team Leader.
• Explain the role of ‘time-outs’.
• Emphasise that requests for any additional support
needed by team members must be communicated
directly to the Team Leader.
• Explain the role of additional providers who may
arrive after the team has commenced treating the
patient.
And a section on communication…..
Communication for Team Leaders

• Taking Hand Over

• Running the team
• Introducing new members (latecomers) to
the team
• Speaking to the patient and their family
Good Communication for the
Trauma Team
• Directed (person to person)
• Clear and Concise
• Repeats important information and
confirms
• Voice level but audible
• Relevant to the situation
• Uses ‘time outs’ for discussion
Not so good (ie. bad) Communication

• Everyone talking at once

• Lots of questions, no actions or answers
• Raised voices
• Contributions which are unsolicited fleeting
opinions (UFOs)
Potential Conflict Causing Situations

• Team members not aware of roles

• Team members lack competencies
• UFOs
• Latecomers joining in “any old where”
• Difficult clinical decisions/definitive care
 Helping Resolve Conflict
Be Aware –

• Not everyone is the same.

• A good team uses everyone’s skills.

• Everyone has a voice but only one leader.

• Team Leaders need to be role models.

Conflict Resolution and Difficult Clinical
Decisions

• Remember where you came from -

ABCDE
• Remember the rules of good
communication!
• Remember what’s best for the patient
 And The Team must always
remember ATLS Principles….

• Do no further harm.
• Treat greatest threat to life first.
• Time is of the essence.
• One safe way.
 Debriefing The Team (Pendleton
Plus)

• What went well.

• What could have been done differently.
• What have we learnt for next time.
• Are there any actions we need to take eg.
team resources, equipment, training.
 Chapter Additions
• 10th Edition Manual includes a short
section at the end of each chapter on how
the Trauma team may manage this area.

• UK faculty will receive additional

information in the form of a more detailed
set of Chapter Additions suited to UK
practice.
 Trauma Team Video
• Provide a resource for all UK ATLS
centres.
• Describe one safe way.
• Demonstrate Team Leaders and members
roles.
• Touch on dealing with conflict.
 Trauma Team Video
• Screenplay – Ros
• Narrators – Steve and Hayley
• Trauma Team – Jonathan, Bob, Lara,
Harry, Rob
• Playing Himself – Stuart

• Showing at a cinema near you now!!

Delivery of the Trauma Team
Core Content in the ATLS 10th
Edition
Course Directors and Co-ordinator
• New course format and timetable.
• 45 minute skill station on second day for
Trauma Team skills and delivery of core
content.
• Not assessed in MCQ or Initial
Assessment skill stations.
 Format of Trauma Team Skill
Station
• Introduction by Course Director and faculty.
• Video (21 minutes)
• Interactive discussion to follow focussing on:
- Role of Team Leader
- Behaviour of Team Members
- Communication within the Team
- Value of good debrief
 ATLS Faculty
• All faculty will receive hard copies of the
Trauma Team Appendix and Chapter
Additions when they sign up to teach on
10th ATLS.
• Please:
– Be familiar with the content
– Give us your feedback
 To Date
• ATLS 10th Edition in print.
• Team Training material has been piloted
on ATLS Reverification courses and 10th
Edition Pilot.
• Further Pilots to follow (there will be more
guidance!)
• Well received so far
Questions
 Summary
• New Core Material on the Trauma Team
will be available in 10th Edition.
• Not designed to dilute the message of an
ATLS Provider Course.
• Will form significant contribution to the
International programme.
• Trauma video