Emergency Trauma Management – A New Hope?
Yesterday, in central Melbourne, the product of many months sweat and toil was finally put on display for public consumption. Amit Maini and Andy Buck, fed up with the rubber stamping process that seems to be the result of a lot of the alphabet courses, have come up with one of their own. Inspired by their recognition that just participating in a XXXX (insert four letters of the alphabet here) course does not always prepare you for the reality of the trauma bay, they have set out to create their own course paradigm. The Emergency Trauma Management (ETM) course does not set out to replace EMST or ATLS, instead it aims to supplement. It aims to help both the doctor in the single-provider setting as well as the trauma team leader in a bust metropolitan trauma centre. Their focus is on interactivity, team work, and Resus room management rather than sitting in stuffy lectures.
Over the course of the day we ran through key elements of the course looking for ways to improve it and anticipate any challenges. As can be expected, when a large number of experienced people come together from a variety of backgrounds there was much debate, over everything from the physical layout of the rooms and choice of chairs to how up to date with current literature we need to be. Amit Maini ran through the opening ETM lecture with the obligatory montage of trauma porn and an interesting point was raised as to how footage of cars repeatedly crashing into each other might be great for the Top Gear obsessed male candidates but might alienate some of the female course goers. Without this preliminary focus group work this might never have even been considered.
So what did I like about the day?
The course manual is amazing. It has been designed predominately as a fully indexed and searchable iBook with key chapters dealing with everything from trauma reception to Resus room management and everything in between. By moving away from a traditional pen and paper manual they have been able to incorporate interactive quizzes, hyperlinks to on-line FOAMed resources and videos. They have gathered a who’s who of the great and good in SoMe and trauma to add their expertise. So with chapters written by Scott Weingart, Mike Mallin, Matt Dawson and Casey Parker you know you are in for a treat. There are even a chapters in there by Minh, in case you haven’t had enough of him.
Amit and Andy have recognised that there are often dissenting opinions on the best way to do things and have embraced this. They are happy to admit that there are a number of ways of achieving ‘tracheal access’ and that no one way is the right way. I spent the afternoon teaching the scalpel-finger-bougie technique with half of my mock candidates reading out the latest ‘discussion’ between Minh and Nicholas Chrimes.
It was great to be in a course and the first sign I see is the ETM course free WiFi password. Chris Edwards, Cheryl Martin, John Dyett and Jeram Hyde were able to tweet out discussions over areas of contention without getting to noisy.
The November and December courses have already sold out and I’m heading back to the UK for a well earned Christmas break so I won’t get the chance to be heckled by Tim.
So who is the course aimed at? Well, there was a real mix of individuals trying it out, from junior and senior EM registrars to critical trainees and rural clinicians. One criticism that could be levelled at the course is that it seems very emergency-centric but I think it would also be useful for surgical and anaesthetic trainees that want to try something a little less dogmatic that allows them to think for themselves.
Conflict of interest declared: I’ve written the chapters on intra- and inter-hospital transfer of patients and received a really tasty chocolate frog for helping out on the day.