Education

Managing Trauma Patients in the Community: U of T Trauma (St. Michael’s, Sick Kids, Sunnybrook)

Dear Trauma and ED Colleague,

We are excited to share with you our brand-new Trauma Care White Board Video. Based upon an identified need for trauma education resources, we sought to create a unique video that delivers high yield information on community trauma management and transport. This project was a collaborative effort with input from a diverse group of community and academic pediatric and adult trauma care providers and covers important commonalities and differences when caring for diverse patient populations. Of note, the video briefly references Ontario specific trauma services, however, the core content of the video is applicable to trauma care across Canada

Funding for the video was provided by University of Toronto Trauma & ACS, Sunnybrook Hospital, SickKids and St. Michael’s Hospital. The primary authors and developers of the video: Dr. Alun Ackery (SMH), Dr. Suzanne Beno (SickKids), and Dr. Kealin Wong (UofT, PGY2) have no conflicts of interest to declare.

Trauma Resuscitation in Kids (TRIK) is a two-day simulation-based course. It is designed for health care providers in Canada and abroad who manage pediatric trauma patients, with a focus on the roles of team leader and team members.

The TRIK course is suitable for emergency physicians, pediatricians, general surgeons, pediatric surgeons, family physicians, critical care physicians, emergency nurses and respiratory therapists. It is an accredited Section 1 and 3 learning activity as defined by the Royal College’s Maintenance of Certification Program. We recommend that participants have current certification in advanced trauma life support (ATLS) before taking this course.

Upcoming Courses

March 2 & 3, 2019 at Alberta Childrens Hospital KidsSim Centre (held in conjunction with the TAC conference)- Registration link is on TAC conference website

http://www.cccip.ca/introduction/

Injury (trauma) remains a major health care problem throughout the world. In addition to improving prevention and resuscitation, improved application of surgical skills is expected to save further lives and contribute to minimizing disability. It is widely recognized that training of surgeons in the management of trauma is substantially deficient because of:

(a) Limited exposure within individual training programs to the types of patients required to develop the appropriate level of skills and

(b) Traditional trauma surgery training, which has been organ specific but not well grounded in the management of multiply injured patients with competing priorities.

Consequently surgeons can finish training with sub-optimal skills in this field where there is often little time to contemplate an appropriate course of action.

Through the early 90’s it became apparent, to a number of surgeons familiar with trauma management around the world, that there was a specific need for surgical training in decision making and the technical aspects of operative care of the trauma patient, placing particular emphasis on those who were close to, or had recently completed their training. DSTC had its origins in a meeting between Howard Champion (USA), David Mulder (Canada), Donald Trunkey (USA), Stephen Deane (Australia) and Abe Fingerhut (France) in October 1993.

This postgraduate surgical course for 20 participants assumes competence with assessment and resuscitative measures, which have become standardized in North America through The American College of Surgeons ATLS® Course. It draws on the specialist surgical training of all course participants and reviews, strengthens and organizes the performance of established and new procedures specially required in trauma surgery. Courses have been conducted in Europe, USA, Asia and Australia. It is expected that this standardized course will have special relevance for surgeons in countries like Canada and Australia, where major trauma rates are relatively low and to rapidly mobilized medical units in areas of conflict. It is also likely to be valuable in developing countries where education and physical resources are limited.

DSTC has developed in many continents under the umbrella of IATSIC, International Association for Trauma Surgery and Intensive Care. This fourth Canadian DSTC Course is being promoted by the Trauma Association of Canada and Trauma Services, Vancouver General Hospital. Increasingly it is being recognized that DSTC is an outstanding educational event meeting the very real needs of surgeons caring for the injured.

A mixture of manual and lecture based learning, case discussion and surgical skills demonstration and practice.

• Manual addressing “Physiology and Organ Support”, decision making in trauma surgery and surgical techniques.
• Two theory sessions addressing technical surgical strategies
• Two sessions addressing strategic thinking in Trauma Surgery
• Two practical session addressing technical surgical strategies
• One session on troubleshooting

The course will run for two days with the following course materials:

• A manual to supplement the course content
• Standardized Slides
• Practical and technical skill stations
• Patient scenarios in acute trauma surgery
• Practical work laboratory using animals and cadavers
• Participant members are limited to 20 in DSTC courses with a high faculty to participant ratio, allowing for two faculty
members to four participants in hands-on practical skill sessions.

This session will provide hands-on exposure to operative techniques in a small group with a high faculty/participant ratio.

March 6-8, 2019 in Vancouver
April 10-11, 2019 in Montreal

TBD

The Society of Trauma Nurses (STN) TOPIC course is taught to all members of the trauma system team who participate in the ongoing assessment, evaluation and improvement of trauma care. The STN has developed the “Trauma Outcomes and Performance Improvement Course” in response to the need for education and better understanding of the Performance Improvement process in trauma care. TOPIC focuses on the ongoing assessment of the continuum of trauma care with a structured review of process and discussions of strategies to monitor trauma patient outcomes

CLICK HERE for more information & course dates

Developed by the Rural Trauma Committee of the American College of Surgeons Committee on Trauma, RTTDC is based on the concept that in most situations, rural facilities can form a trauma team consisting of at least three core members.  The course is offered in a single day or modular format.

The intended audience includes individuals who are involved in the care of the injured patient, including physicians, nurse practitioners, physician assistants, nurses, prehospital personnel, technicians and administrative support. The Society of Trauma Nurses is now offering the Rural Trauma Outcomes and Performance Improvement Course online. This course will provide education and a better understanding of the Performance Improvement process in trauma care to Level 4 and Level 3 (those in small communities or low trauma volume) trauma centers.

• Organized rural trauma team with defined roles and responsibilities for the members
• Prepare a rural facility for the appropriate care of the injured patient
• Identify local resources and limitations
• Assess and resuscitate a trauma patient
• Initiate the transfer process early
• Establish a performance improvement process
• Communication effective
• Define the relationship between the rural trauma facility and the regional trauma system

The American College of Surgeon is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American College of Surgeons designated this Live Activity for a maximum of 8.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The American Nurses Credentialing Center (ANCC) accepts AMA PRA Category 1 Credits™ issued by organizations accredited by the ACCME.

Other non-physician participants will receive a certificate of course completion that they can use to claim credits from their respective credentialing entities.

The Advanced Trauma Life Support (ATLS) course is the gold standard of trauma care throughout the world. The Simulated Trauma and Resuscitation Team Training (S.T.A.R.T.T.) course builds on the ATLS principles but focuses on grooming an effective and efficient trauma team. It highlights trauma team design and organization and the differences between trauma management in a Level 1 trauma centre versus ATLS based management designed for a single practitioner in a rural setting. The course focuses on crisis resource management (CRM) training in order to teach participants how to effectively function as a member of a multidisciplinary trauma team. We emphasize: communication and leadership skills, effective resource utilization, situational awareness and problem solving, and how to enhance completion of tasks.

The course consists of a brief didactic session discussing the principle of CRM training and the history and rationale behind CRM. The remainder of the day will consist of small groups rotating through a number of high-fidelity trauma simulations. Each will be followed by an extensive debriefing session by experienced trauma team members discussing not only the medical content of the scenario but also focusing on communication and leadership skills and applying the CRM principles from the morning session.

By the end of this course the participant will be able to:

1)    discuss the history of crisis resource management training and the rationale for trauma team member training

2)    describe the principles of crisis resource management including problem- solving approaches, situational awareness, limited resource utilization, leadership and communication skills

3)    highlight the similarities and differences between a sequential ATLS approach to trauma management versus a parallel, simultaneous approach used in level 1 trauma centres

4)    understand the organization of the trauma team and the roles of each of its members

5)    have the opportunity to demonstrate and practice these skills by acting as a trauma team member during a simulated trauma resuscitation

The course is aimed at all trauma team members including :emergency physicians, surgeons, nurses, respiratory therapists and their respective trainees interested in enhancing trauma team skills. Previous ATLS training is ideal though not essential.

Contact Dr Lawrence Gillman (course founder) at lawrence.gillman@umanitoba.ca

2013 Faculty Members (Left to Right):

Lawrence Gillman, BJ Hancock, Paola Fata, Tarek Razek, Kosar Khwaja, Sandy Widder, Vivian McAlister, Markus Ziesmann, John Kortbeek, Morad Hameed, Paul Mcbeth, Paul Engels, Peter Brindley, Damian Paton-Gay

2012 Faculty Members (From Left to Right):

Damian Paton-Gay, Paul Engels, Kevin Stevenson, Cliff Yaffe, Kevin Pugh, Arthur Tse, Peter Brindley, Lawrence Gillman, Christopher Hicks, Sandy Widder, Markus Ziesmann, Morad Hameed, John Kortbeek, Kosar Khwaja

Emergency Nurse

• Great job! Thank you.
• I think bringing allied professionals together to learn is the most effective way to teach them how to work as a true trauma team. More simulation would bring safer more rewarding experiences to RNs, RTs and residents.

Respiratory Therapist

• I had a great time! Excellent learning opportunity and I will take this back to my home site!
• A wonderful course. Well organized and enjoyed the diverse group and dynamic. I felt it was a safe learning environment and I learned a lot. Please do more courses like this! LOVED IT!!
• Thanks for excellent opportunity. Speakers were great!

Surgical Resident – Program (Fellow)

• Outstanding course – great at teaching the non-medical dimensions/complexities of trauma resuscitation and how and why they matter for patient outcomes. Thank you.

Surgical Resident – Program (PGY year 2)

• Excellent work. Very interesting and thought provoking with great attention to our learning needs. The course covered lots that we are not exposed to via normal residency training. Thanks!
• Great course! Well organized.
• Perhaps the nurses and RT’s could know more about the simulation (i.e. what things are available etc.)
• Good job, got more than what I expected; very welcoming team.
• Excellent course

Surgical Resident Program (PGY year 3)

• Really good – wish we could do more simulations! All handout to address “goal/ideal” medical treatment would be helpful to residents and not take time away from debriefings.
• Probably have time for more simulations (5-6). Review particular skills (eg. Closing the loop, escalation) prior to individual stations so specific skills can be focused on and developed. Surgical Resident – Program (PGY year 4)
• Excellent course. Good practice of communication skills in a trauma setting. Would recommend more scenarios, and less down time. Had a great experience.
• Fantastic course!
• Please don’t be turned away by all the ‘5s’ in the last section – I truly feel that way. This course should be made obligatory as it focuses on fundamental skills of communication and leadership. Strongly recommended. Surgical Resident – Program (PGY year 5)
• Very effective debriefing sessions.