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Cutting-Edge Chronicles: A Surgical Safari Through the ATLS Course

Hi, I am Dr Sharwani Hirurkar, a junior doctor from India. I’ll be starting my first job in the

NHS as a Junior Training Fellow in Cardiothoracic Surgery in August 2023.

Advanced Trauma Life Support (ATLS) is an internationally renowned course for medical professionals that teaches them how to treat trauma patients in a methodical manner and is relevant to all specialities. One of the most in-demand surgical courses, it is a certificate programme with a four-year validity period.

In today’s blog, I will be discussing the following:

1) What is the ATLS course, and how will it benefit you?

2) How much does it cost? Where can you book a slot?

3) What should one do after signing up for the ATLS course?

4) What is the structure of the course? Structure of my ATLS Course.

5) Successful course completion. What will happen if you fail?

6) My personal experience of the course and some key ideas to help you ace your ATLS course.

What is the ATLS course, and how will it benefit you?

Advanced Trauma Life Support, or ATLS, is a two- or three-day interactive training offered by several organisations, including the Royal College of Surgeons in the UK. The American College of Surgeons also provides it in other nations. A healthcare practitioner who completes this course will be able to treat traumatically injured right away and deal with patients who have life-threatening injuries methodically. Not only is the programme one of the most in-demand, but it also demonstrates your dedication to the surgical specialty and looks fantastic on your resume when searching for employment. Additionally, this course is essential for passing the MRCS Part B test since the Critical Care portion may include a scenario based on the ATLS Protocols.

How much does it cost? Where can you book a slot?

Depending on the centre you book, the cost of this course ranges from 600 to 800 GBP. You can always enquire your trust about a study budget that may be available for you to claim and use that as well.

The American College of Surgeons supplied the training, which I took in my native country. I spent roughly 250 GBP on it, excluding the travel and lodging costs. The official website of the Royal College of Surgeons allows you to reserve a slot. What should one do after signing up for the ATLS course? You will get access to pre-course learning modules and videos once you have finished enrolling for the course and making your payment. You can review these resources before the course begins. Additionally, you must complete a pre-course Questionnaire, known as the PRE TEST #1, which consists of multiple-choice questions (MCQs), and turn it in on the morning of the first day.

Apart from that, an ATLS student manual will be provided, which you must read before the training. This will not only help you perform well on the multiple-choice test but will also give you a general understanding of the sessions and be quite helpful when interacting with the instructors. The handbook also includes a triage scenario booklet.

On the first morning of the course, you are given a copy of the course schedule at the registration desk. What is the structure of the course?

The emphasis of the course is on the "first hour" of trauma management, which begins at the scene of the accident and includes initial assessment, life-saving intervention, re- evaluation, stabilization, and, if necessary, transfers to a hospital with the resources and capabilities to handle the patient.

The course comprises written pre- and post-course exams, lectures on the course's core material, case studies, discussions, the development of abilities that might save a person's life, hands-on lab experiences, interactive skill sessions, and a final performance proficiency assessment.

The training equips clinicians with a single approved technique for safe, rapid care as well as the fundamental information to assess and manage the trauma patient to guarantee the best possible result. You will be divided into groups of four people and you will practice the moulage situations and participate in the practical skill workshops with this group. The structure of my ATLS course: Day 1: • 0700-0730: Registration / Faculty meeting / Breakfast • 0730-0745: Welcome & Introduction • 0745-0805: ATLS Course Overview • 0805-0845: Initial Assessment and Management (Interactive Discussion) • 0845-0900: Initial Assessment and Management (Demonstration) • 0900-0915: Critique & Discussion • 0915-0930: BREAK • 0930-1000: Airway and Ventilatory Management (Interactive Discussion) • 1000-1030: Shock (Interactive Discussion) • 1030-1110: Thoracic Trauma (Interactive Discussion) • 1110-1140: Abdominal & Pelvic Trauma (Interactive Discussion) • 1140-1210: Paediatric Trauma (Interactive Discussion) • 1210-1245: LUNCH • 1245-1645: Practical Skills Station (60 minutes for each station)

1. Station I: Basic/Advanced Airway Management 2. Station II: Breathing 3. Station III: Circulation 4. Station IV: Paediatric Airway and Surgical Cricothyrotomy

• 1645-1700: BREAK • 1700-1740: Pretest Group Discussion • 1740-1750: Day’s Summary/Adjourn (Faculty Meeting) Day 2: • 0715-0730: Breakfast / Q&A • 0730-0800: Head Trauma (Interactive Discussion) • 0800-0830: Musculoskeletal Trauma (Interactive Discussion) • 0830-0900: Spine and Spinal Cord Trauma (Interactive Discussion) • 0900-0915: BREAK • 0915-1315: Practical Skills Station (60 minutes for each station)

1. Station V: Disability 2. Station VI: Adjuncts 3. Station VII: Secondary Survey 4. Station VIII: Initial Assessment Practise and Team Training

• 1315-1400: LUNCH • 1400-1430: Geriatric Trauma (Interactive Discussion) • 1430-1500: Thermal Injuries (Interactive Discussion) • 1500-1530: Trauma in Pregnancy (Interactive Discussion) • 1530-1610: BREAK • 1540- 1610: Transfer to Definitive Care (Interactive Discussion) • 1610-1710: Triage Scenarios Discussion (In Groups) • 1710-1720: Day’s Summary/Adjourn (Faculty Meeting) Day 3: • 0700-0745: Breakfast • 0730-0800: Faculty meet with patients and assistants • 0800-1100: Skills Station-Initial Assessment Skills Station (One for performing assessment and one to observe/critique the assessment) and Written Test • 1100-1130: Post Course Faculty Meeting/ Selection of Instructor course participants • 1130-1200: Summary/Closure & Group Photo Successful Course Completion: The successful completion of the student course is based on attendance at the entire course, adherence to the course content, demonstration of the practical skills as outlined in the manual, and demonstration of knowledge and proficiency per the course requirements:

1) Performance at each of the skills station 2) Successful completion of the written Post Test with a score of AT LEAST 80%. 3) Performance at the Initial Assessment Testing Station For one to advance to Instructor Course, one must first complete the student course and be identified as having instructor potential.

What will happen if you fail?

• If you fail the MCQ test and have passed all the other assessments, you will be given another chance to sit for it, but it may not be on the same day. • If you passed the MCQ Test, but failed the Initial Assessment Testing Station, you will be given another chance on the sameday. • If you fail the Initial Assessment Testing Station the second time, you may be given a third chanceon another day after some time (depending on what the Course Director decides) My personal experience of the course: One of the most difficult and sought-after surgical courses I've taken so far is ATLS. Although the three days were demanding, exciting, and stressful, they helped me develop a methodical approach to working with trauma patients. I completed this course long before I began working for the NHS. It not only helped me become competent, but it also boosted my self-esteem. All of the interactive discussions saw us students talking 80% of the time, with the teachers guiding us and ensuring that our brains were working at maximum capacity.

I found the course to be challenging and engaging. Throughout the duration of the course, I kept an open mind and made the internal decision that I would leave with a vast amount of knowledge. I listened intently to the interactive sessions and then read through the manual's coverage of the day's themes. My ability to connect the theory with the practical portion truly helped me internalise the ideas. Even though I was anxious, my Moulage scenario on the last day had a patient who had been in a road traffic accident and had a fractured femur. I only had to follow the ATLS Way from beginning to end. I did well and received accolades from the instructors as well. Some key ideas to help you ace your ATLS course: 1. Watch the pre-course videosand readings at least twice. 2. Ensure that you completely study the ATLS Student manual—at least twice. 3. Continue to revise the algorithm. 4. Attend lessons with an open mind and pay close attention to everything that is said. 5. Get out there and network; you need to locate mentors who will help you along the path. You occasionally wind up forming relationships that are more profound and long-lasting. Need some help? You can register using this link. I hope my post will help those who are preparing for the ATLS Course. Good Luck,

Dr Sharwani Hirurkar

Resources I used:

1. Royal College of Surgeons, England official website.

2. Handouts detailing my course schedule and structure.


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