Advanced trauma life support study: Quality of diagnostic and therapeutic procedures

Background: The introduction of the ATLS(R) course in the Netherlands in 1995 provided for an opportunity to compare data of trauma patients between a preATLS(R) and a post-ATLS(R) period. Materials and methods: Over a 3-year period (May 1996 - September 1997 pre ATLS(R); December 1997 - April 1999 post ATLS(R)) 63 trauma patients with an AIS-ISS greater than or equal to 16 (n = 31, preATLS(R) and n = 32, post-ATLS(R)) were prospectively studied in two community residency training (ACS Level III) hospitals. All diagnostic and therapeutic procedures were recorded by a video-camera and evaluated by a neutral faculty of six experienced ATLS(R) trained specialists. Results: Ten out of 14 interventions were performed qualitatively better in the post-ATLS(R) group, while also the overall score was highly significantly better (4.2 pre-ATLS(R) and 5.8 post-ATLS(R), p < 0.0001). Conclusion: Using the opinion of an expert team, this study identified a significantly lower number of patients with inadequate management.