Training in 'advanced trauma life support' (ATLS) is increasingly used in both rich and poor countries. ATLS is intended to improve the way in which care is given to injured people, thereby reducing death and disability. Some research has been done that suggests ATLS programmes improve the knowledge of staff who have been trained, but there have been no controlled trials to show the impact of ATLS-trained staff (or staff trained in similar programmes) on the rates of death and disability of injured patients themselves. The review calls for more research and puts forward suggestions about how future research might be conducted.
Baca abstrak penuh
Injury is responsible for an increasing global burden of death and disability. As a result, new models of trauma care have been developed. Many of these, though initially developed in high-income countries (HICs), are now being adopted in low and middle-income countries (LMICs). One such trauma care model is advanced trauma life support (ATLS) training in hospitals, which is being promoted in LMICs as a strategy for improving outcomes for victims of trauma. The impact of this health service intervention, however, has not been rigorously tested by means of a systematic review in either HIC or LMIC settings.
Matlamat
To quantify the impact of ATLS training for hospital staff on injury mortality and morbidity in hospitals with and without such a training program.
Kaedah Pencarian
The search for studies was run on the 16th May 2014. We searched the Cochrane Injuries Group's Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), Ovid MEDLINE(R), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R), Embase Classic+Embase (Ovid), ISI WOS (SCI-EXPANDED, SSCI, CPCI-S & CPSI-SSH), CINAHL Plus (EBSCO), PubMed and screened reference lists.
Kriteria Pemilihan
Randomised controlled trials, controlled trials and controlled before-and-after studies comparing the impact of ATLS-trained hospital staff versus non-ATLS trained hospital staff on injury mortality and morbidity.
Pengumpulan Data dan Analisis
Three authors applied the eligibility criteria to trial reports for inclusion, and extracted data.
Keputusan Utama
None of the studies identified by the search met the inclusion criteria for this review.
Kesimpulan Pengarang
There is no evidence from controlled trials that ATLS or similar programs impact the outcome for victims of injury, although there is some evidence that educational initiatives improve knowledge of hospital staff of available emergency interventions. Furthermore, there is no evidence that trauma management systems that incorporate ATLS training impact positively on outcome. Future research should concentrate on the evaluation of trauma systems incorporating ATLS, both within hospitals and at the health system level, by using more rigorous research designs.
