Does Advanced Trauma Life Support Training work? 10-Year Follow Up of Advanced Trauma Life Support India Program

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Does Advanced Trauma Life Support Training work? 10-Year Follow Up of Advanced Trauma Life Support India Program


JournalJournal of the American College of Surgeons
Article typeJournal research article – Clinical research
Publication date – May – 2021
Authors – Amulya Rattan, Amit Gupta , Subodh Kumar , Sushma Sagar , Suresh Sangi , Neerja Bannerjee , Radhesh Nambiar , Vinod Jain , Parli Ravi , Mahesh C. Misra ,
KeywordsATLS, India program, LMICs, Survey instrument
Open access – Yes
SpecialityHealth policy, Trauma surgery
World region Southern Asia
Country: India
Language – English
Submitted to the One Surgery Index on May 15, 2021 at 3:34 am
Abstract:

Background
Studies evaluating the efficacy of ATLS in Low & Middle-income countries (LMICs) are limited. We followed up ATLS providers certified by ATLS India program over a decade (2008-2018), aiming at measuring the benefits, if any, in knowledge, skills & attitude (KSA) from ATLS, and attrition over time.

Methods
Survey instrument was developed taking a cue from published literature on ATLS and improvised using the Delphi method. Randomly selected ATLS providers were sent the survey instrument via email, as a Google form along with a statement of purpose. Results are presented descriptively.

Results
1030 (41.2%) doctors responded. Improvement in knowledge (n=1013; 98.3%), psychomotor skills (n=986; 95.7%), organizational skills (n=998; 96.9%), overall trauma management (n=1013; 98.7%), self-confidence (n= 939; 91%) and ATLS promulgation at workplace in personal capacity (904; 87.8%) were reported. More than 60% opined benefits lasting beyond two years; more than 40% opined cognitive (492; 47.8%), psychomotor (433; 42%), and organizational benefits (499; 48.4%) lasting beyond three years. The Faculty-ATLS subgroup reported significantly more improvement in confidence, tendency to teach ATLS at the workplace, and retention of organizational skills than the providers’ subgroup. Lack of trained manpower (660; 64.1%) & attitude issues (n-495; 48.1%) were the major impediments at workplace. One third (n=373; 36.2%) recalled & enumerated life/ limb saving incidents applying ATLS principles.

Conclusion
Cognitive, psychomotor, organizational, and affective impact of ATLS is overwhelmingly positive in the Indian scenario. Till establishing formal trauma systems, ATLS remains the best hope for critically injured patients in LMICs.

OSI Number – 21082

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