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23rd European Congress of Trauma & Emergency Surgery

Advanced Trauma Life Support (ATLS) courses as a bridge for cooperation and working together for Palestinian and Israeli physicians

Education

Trauma and Emergency surgery | Miscellaneous

Introduction: Working together is a fundamental tenet of improving outcomes for trauma victims. Advanced Trauma Life Support (ATLS) constitutes the foundation to optimize this care, and serves as a common language between providers. ATLS embodies the principles of teamwork, and therefore can facilitate respectable and sustainable partnerships between Palestinian and Israeli peers, while advancing trauma care. Objectives: To evaluate the perspectives of joint ATLS courses with Israeli and Palestinian participants. Materials &amp; Methods: ATLS courses were conducted in equal groups of Palestinian and Israelis. Subjective and objective data were collected, together with interviews within Palestinian and Israeli focus groups. Results: One hundred and thirteen physicians participated in six courses, nineteen underwent in-depth interviews. In response to, what were your overall feelings about the course?, there was an average score of 9.1/10. Ninety-three percent of the participants answered &quot;yes&quot; to wanting to maintain professional contact with their peers, and 63% said they would be interested in participating in social gatherings involving families. Response to the interviews showed that 95.6% felt that the course had a positive benefit to their daily work. 82.4% had a positive response to cooperating and working together. Nobody disagreed, and 89.5% agreed that either of these groups face discrimination in their daily lives. Conclusion: ATLS, and other similar initiatives that focus on teamwork and cooperation are ideal pathways to facilitate professional and personal relationships between Palestinians and Israelis. Such endeavors improve the treatment of trauma patients, advance the regional trauma system, and provide a framework for meaningful and sustainable relationships. No

Poster

Dr. med.

PD Dr. med.

Performing advanced trauma life support (ATLS) across borders: Midterm follow-up of the aeromedical evacuation after civilian bus accident at Madeira

Polytrauma

Introduction: On 17 April 2019, a coach with tourists from Germany crashed in Madeira, requiring repatriation by the German Air Force. The Advanced Trauma Life Support (ATLS) concept was the central component of patient care. Material&amp;Methods: Data in Madeira were collected through a structured interview. The analysis of the Aeromedical Evacuation was based on intensive care transport records. In Germany, all available medical data sheets were reviewed for data collection. Quality of life (HRQoL) was evaluated by the 12-item Short Form Health Survey (SF-12). Results: Twenty-eight prehospital patients were transported to the Level III Trauma Center in Funchal (Madeira). Five operative procedures were performed. Fifteen patients were eligible for Aeromedical Evacuation (AE). In the second hospital phase in Germany, in total 82 radiological images and 9 operations were performed. Hospital stay lasted 11 days (median, IQR 10–18). Median follow-up (14 of 15 patients) was 16 months (IQR 16–21). Eighty percent (8 out of 10) showed an increased risk for post-traumatic stress disorder (PTSD). Conclusions: Six key findings were identified in this study: divergent injury classification, impact of AE mission on health status, lack of communication, need of PTSD prophylaxis, patient identification, and media coverage. Those findings may improve AE missions in the future, e.g., when required after armed conflicts.No

Prof.

The Estonian Definitive Surgical Trauma Care + Definitive Anesthesia Trauma Care (DSTC+DATC) program innovate a stop the bleed instructor module

Introduction: The DSTC -DATC course is presently provided in over 25 countries. Its objective is to empower surgical and anesthesia teams to improve their skills in treating trauma patients. Our study introduced an initiative combining the DSTC-DATC course with a Stop the Bleed (STB) Instructor Program. Methods: In 2022, a new program was launched as part of the annual DSTC+DATC course in Estonia. This unique program trained instructors in the Nordic countries (Estonia, Finland, Norway, and Sweden) on implementing the STB course. This approach combined surgical and anesthetic trauma care with hands-on training. Through this training, instructors were equipped with the necessary knowledge to develop bleeding control programs for the immediate responders in their countries. Results: In Tartu, Estonia, a three-day course was successfully conducted for 15 international faculty members from various European countries. The organizing committee arranged a unique two-hour faculty program on STB for all DATC+DSTC faculty members. The instructors were given lectures and hands-on training on bleeding control skills. These skills were then shared with the course participants, totaling 28 attendees. The course also included live animal labs, which provided a practical experience for the participants. The faculty members were also trained to effectively adjust and implement the STB program in their home countries. This training allowed them to integrate the program independently or as an addition to the DATC+DSTC program. Conclusion: The DSTC+DATC courses provide one-of-a-kind chances to enhance trauma team management abilities through animal labs and simulations. By incorporating STB content, participants can further improve their bleeding control skills. Additionally, this contributes to the development of STB regional leaders, ultimately increasing the recognition and growth of the STB program. This innovation serves as the foundation for the DSTC+DATC+STB concept.None

Prof. Dr.

PD Dr. med

PD Dr.

Evaluation of the decision-making-process within the table-top exercise of the Terror and Disaster Surgical Care (TDSC®) course

Research

Purpose The threat of terror is omnipresent in Europe and the number of attacks worldwide is increasing. The target of attacks in Europe is usually the civilian population. Incalculable dangerous situations at the scene of the event and severe injury patterns such as complex gunshot and explosion injuries with a high number of highly life-threatening people present rescue forces, emergency physicians and subsequently hospitals with medical, organizational as well as tactical-strategic challenges. The Terror and Disaster Surgical Care (TDSC®) - course trains clinical decision makers to meet these challenges of a TerrorMASCAL in the first 24 to 48 hours. Methods A table-top - exercise was developed for the TDSC® - course as a decision training tool, which was prospectively evaluated in six courses. The evaluation took place in 3 courses of the version 1.0, in 3 courses in the further developed version 2.0 to different target values like e.g. the accuracy of the in-hospital triage. Further one 16 TDSC® - course instructors were also evaluated. Results For the evaluation n=360 patient charts for version 1.0 and n=369 for version 2.0 could be evaluated. Overall, the table-top exercise was found to be suitable for training of internal clinical decision-makers. Version 2.0 was also able to depict the action and decision-making paths in a stable and valid manner compared to the previous version 1.0. The evaluation of the instructors also confirmed the further value and improvement of version 2.0. Conclusion With this prospective study, the table-top - exercise of the TDSC® - course was tested for decision stability and consistency of the participants' decision paths. This could be proven for the selected target variables, it further showed an improvement of the training situation. A further development of the table-top - exercise, in particular also using digital modules, will allow a further optimization.Reckziegel A is a medical doctoral student evaluating the TDSC course and its simulation game, Achatz G, Friemert B, Franke A and Bieler D are developers of the TDSC course and active as course directors/instructors. Blätzinger M work for the AUC - Academy for Trauma Surgery GmbH and are organisers of the TDSC course.

Impact of basic life support training with new students from a private medical school in Brazil

Introduction: Basic Life Support (BLS) constitutes training protocols for patients in clinical emergencies and includes early identification of cardiorspiratory arrest (CPA) and cardiopulmonar resuscitation (CPR). Those techiniques can be applied by anyone previously trained and save lives while more advanced medical services are activated. For this reason, educational actions are important. Objectives: Verify knowledge before and after training in BLS practices in those entering a Medical School in the interior of the State of São Paulo. Materials and methods: A theoretical form with 10 multiple choice question was applied to the students on the first day at the University. Subsequently, they received instruction (theorical and pratical on dolls) regarding BLS protocols by participantes of &quot;Trauma Prevention&quot; Extension Project that already had BLS course certification by American Heart Association. Then, the questionnaire was reapplied. The test responses were corrected and subjected to statistical analysis, with mean calculation and analysis of the 95% confidence interval. Results: 63 students completed the questionaires during the training. Of these, 71,43% had never had contact with BLS until that moment. The average accuracy of the form before and after the classes was 50,31% (CI95% 46,42 – 54,22) and 95,35% (CI95% 93,39 – 96,85), respectively. The question with the biggest satistical variation was &quot;What is the first step in approacing a victim with suspected CA?&quot;. During the practical training, the extension group corrected aspects such as the student&quot;s positioning if the hands, frequency and depth of compressions and chest return, characteristics to grarantee CPR high quality. Conclusion: The training increased the new entrants knowledge about BLS. The results of the educational action were positive and relevant for the Extension Project, which seeks to expand training activities for other courses and professionals at the University. References: 1. AHA No

ACE-Pro: A faculty development course for trauma procedure teachers

Introduction Trauma management has evolved over the years and since the development of ATLS, many more skills have been added to the repertoire of skills that frontline trauma providers have to learn. In addition, trauma and emergency residency instructors have to teach some rare procedures that they might not have learnt when they were in training nor had they encountered in clinical practice. Examples of these procedures include amputations, pericardiocentesis and resuscitative thoracotomy. In order to meet the need, a procedures course was created to teach instructors how to perform as well as teach the the procedural skills using evidence-informed methods. This is a train-the-trainer course for trauma and emergency residency faculty. Objectives The objective of this presentation is to share how we used evidence-nformed education methods develop the Acute and Critical Emergency Procedures Course (ACE-Pro). Material and Methods The Kern's model of curriculum development was employed. The aim was to ensure that faculty experienced the course in an educational and evidenced informed way. Faculty had to do pre-course survey of needs analysis. They received videos for pre-course learning. Literature on evidence-based learning methods for teaching strategies for precedures were shared. Faculty were taught procedures using cadaveric specimens. They were encouraged to share their difficulties and their tips on the procedures. Post course evaluation and assessment on their learning was performed. Results There were 44 participants in 2 courses. All faculty learners agreed that the course was relevant to their jobs, that they had learnt new skills and were able to apply on the job. In addition they were able to reflect on and describe how they might use the teaching methods to teach in the future. Conclusion Usng evidence-based educational methods, we were able to run a successful procedures course for trauma and emergency residency teachers.Nothing to disclose.

Should trauma care education be integrated in medical school curriculum?

Disaster & military surgery

Introduction: Medical schools are increasingly adding trauma, triage, and mass-casualty management to their medical curricula. Hadassah-Hebrew University Medical Center places special emphasis on trauma education for medical students and introduced an integrated 3 level educational activities for medical students based on their clinical experience and needs. The study aims to present our educational agenda and promote those activities for other medical schools. Methods: Trauma care curriculum is presented. All educational activities include pre and posttest, video presentation accordingly to topics (frontal lectures were replaced by prerecorded lectures), interactive presentations, practical skills sessions, mock-drills and self-assessment tasks. Both objective and subjective assessments were included. Results: Pretest and posttest MCQ results were analyzed both for student performance and for the assessment of the reliability of the questions by the university statistics department. As expected, correct answers for the posttest results were higher each year, with good reliability. On average, 86% of feedback charts were eligible for evaluation (completed charts). Rating included general organization of the course, the acquisition of knowledge as a result of participating in the course, technical skills acquired, and decision-making ability. Best scores were achieved in knowledge acquisition and practical skills gained. Students were also asked whether the course contributed to self-preparedness in treating trauma patients, and this has consistently achieved the highest scores during the last 3 years. Conclusions: We recommend that trauma training evolves as medical students mature in their clinical management skills. This includes participation in skills activities and drills where students fulfill useful roles. We strongly recommend that our student trauma teaching experience could be implemented as a mandatory educational initiative worldwide. Authors have no conflict of interest

The impact of P.A.R.T.Y. program in students' knowledge and behavior

Introduction: Considering the efficacy of injury prevention programs in reducing trauma´s incidence, the P.A.R.T.Y. Program (Prevent Alcohol and Risk-related Trauma in Youth) has been developed at Clinics Hospital of Unicamp since 2010, in order to sensibilize the participants behavior and reduce their exposure to risky practices. Objectives: Analyze the immediate impact of an afternoon of awareness raising through the P.A.R.T.Y. Program. Patients &amp; Methods: In each edition of P.A.R.T.Y. Program from 2013 until 2017, participants between 14 and 18 years old anonymously answered two questionnaires (before and after the program). The survey with questions regarding epidemiological data referred to a 60-day period prior to the program and general knowledge about trauma and alcohol effects on the human body. Results: Among the 2275 high school participants, 38.5% were male with an average age of 15.9 years. Regarding personal habits, 32.4% reported never using the seatbelt in the front seat, 50.7% claimed being in a vehicle whose driver was drunk at least once, and 18.9% experienced it six or more times. Among those who already drive, 21.6% assumed alcohol-impaired driving. Before the program, 9.3% knew all alcohol effects on the human body and 12.6% believed most road traffic traumas were avoidable. After the program, the percentage rose to 77.6% and 83.2%, respectively. Also, more attendees agreed drunk driving increases the chances of road traffic trauma (66.9% to 84.3%) and 87.2% believed the P.A.R.T.Y. Program would help them to prevent trauma. Conclusion: A relevant percentage were exposed to risk related trauma, and substantial knowledge growth has been observed among program participants regarding theoretical matters discussed during the event. Therefore, it is implied that the students behavior has been positively influenced, reducing their future exposure to unnecessary risks, which is one of the program's main objectives.No

P.A.R.T.Y Program: Evaluating the profile of students from public schools in a city in the interior of the state of São Paulo and promoting traffic safety through educational actions

Introduction: Traffic accidents in Brazil result in around 45,000 annual deaths, presenting itself as a public health challenge. In Campinas, 151 deaths were reported in 2022, 60% linked to speeding and alcohol-impaired driving. Young adults aged 18-29 are notably affected. The P.A.R.T.Y program aims to raise awareness among young individuals about safe road use through informative lectures to prevent traffic accidents. Objectives: To raise awareness among future young drivers about the severity of traffic accidents and their personal, social, and economic impacts aiming to prevent further traffic accidents. Methods: The event ministered to public schools' students about road safety and the dangers of driving under the influence of alcohol and introduced basic life support by visiting victims of car accidents in a hospital. Finally, a questionnaire with objective questions was administered to assess the profile of participating students. Results: A total of 93 high school students participated in the program. Although most of them were underage and couldn't legally drive or consume alcohol, 47% admitted to having driven automobiles, and 42% reported alcohol consumption in the last month. Regarding seatbelt usage, 55% used them only in the front seat, while 28% used them in the back seat as well; 44% of the students were passengers in vehicles driven by individuals under the influence of alcohol. Students also received Basic Life Support training and visited accident victims in the hospital. The results were positive: 61.5% understood the importance of prevention, and nearly 100% believe that the classes were productive. Conclusion: Educational initiatives are crucial in preventing deaths by automobilistic accidents, considering that this age group experiences high mortality rates. It is hoped that young individuals assess their behavior on the road and promote a culture of road safety for the entire population. References: EMDEC. Boletim de Vítimas Fatais, 2022No.

Evaluating medical students' preparedness for polytrauma cases: A cross-sectional assessment

Introduction: Politrauma refers to severe, multiple injuries affecting multiple body regions, often life-threatening. Rapid and correct medical intervention is vital for patient survival and recovery. Given the importance of this topic, understanding the preparedness of medical students towards polytrauma management is paramount. Objectives: To assess the theoretical knowledge and practical skills of final-year medical students regarding polytrauma management and to identify potential gaps in their academic training concerning polytrauma care. Materials &amp; Methods: A cross-sectional study was designed, employing a questionnaire distributed to medical students selected from various medical universities from Romania (Bucharest, Craiova, Iași, Timișoara and Tg. Mureș). The questionnaire encompassed multiple-choice questions, case studies, and practical scenarios. Data analysis was conducted using statistical software, such as SPSS. Results: Preliminary results are expected to provide an assessment of the average knowledge level on polytrauma approach. It will highlight the areas of strength and weakness among the students, pinpointing specific topics where further training might be required. Conclusion: The study will offer valuable insights into the preparedness of medical students towards polytrauma management, guiding academic institutions in refining their curriculum to better equip future doctors in handling such critical medical situations.No

Analyzing emergency medical services effectiveness during a Campinas mass casualty simulation

Introduction: A Mass Casualty Incident (MCI) represents an event that results in casualties that outstrips the ability of the local Emergency Medical Services (EMS) to respond in a normal way. To demonstrate the potential consequences of this situation, a simulation of a traffic accident caused by a motorcyclist that ran over two pedestrians, followed by a subsequent car collision involving a drunk driver, was done in Campinas. Objectives: Evaluate the effectiveness of the support given by EMS at the simulation to analyze the performance of these providers at MCIs. Material &amp; Methods: Each victim of the accident was assigned a student who worked as a &quot;shadow&quot;. These shadows were responsible for gathering data about the triage, annotating the time and the color that the patient was designated. So, through analysis of this data, it was possible to see if the triage was done correctly as well as the time consumed during each step. Results: The average time for the initial support was 5 minutes for the 10 individuals who attended the simulation. Additionally, the triage was done correctly in 70% of cases, and the time that took for the first triage to be done was 8,6 minutes. In 40% of cases, a second triage was necessary, and in 20%, a third triage. The incorrect triages, in 66,6% of cases, underestimated the severity of the injury. Conclusion: Through the simulation, it was possible to identify the difficulties surrounding these types of events, which resides in correctly prioritizing the order of the medical care as a way to promote the best outcome for the patient. By inappropriately triaging at a MCI, a different order of care is applied, which can cause a negative impact on the victim's condition, justifying more simulation training.No.

Trauma prevention and management training project – Joint collaboration between the police / fire fighters and PUC Campinas school of medicine

Brazil has been showing alarming numbers of violent deaths that can be compared to countries in a state of war. According to the Brazilian Public Security Yearbook, between March 2011 and December 2015, there were 278,839 occurrences, compared to 256,124 in Syria. In the state of São Paulo, fewer than 40% of municipalities have access to SAMU, leaving the population in these areas without important pre-hospital care. However, all municipalities have a presence of the Military Police 24 hours a day, seven days a week, making it the only state institution ready to provide assistance in many of these areas. Therefore, adequate training in pre-hospital practices for police officers is of utmost importance to provide quality care to vulnerable areas. Thus, this project formed by faculty and medical students in partnership with the military police and the fire department, aims to teach and disseminate knowledge of basic pre-hospital care to promote better care for communities without access to adequate healthcare systems in a timely manner. The goal is to teach techniques in tactical environments for life protection. These include the application of hemostatic gauze, Israeli bandages, chest seals, and tourniquets according to "Tactical Combat Casualty Care" (TCCC). To enhance this training, participants were given access to the specialized laboratories of PUC CAMPINAS University, along with medical student knowledgeable about TCCC to bridge the gap between the techniques taught and human anatomy and physiology. So far, more than 300 police officers and firefighters have undergone the training, allowing them to apply their knowledge in areas without access to pre-hospital care and to train other public servants to disseminate this knowledge and use it to help as many people as possible. There have already been a considerable number of reports of police officers and civilians who were saved by students of this course using the knowledge provided to them.No

Poster session 18
Education 1

Appointment

Chairs

Topic

Programme

Poster session 18Education 1

Appointment

Chairs

Topic

Programme

Poster session 18
Education 1