Developed in 1979, the Prehospital Trauma Life Support (PHTLS) program has trained more than 600,000 providers in 51 countries. The sixth edition was translated into 11 languages. With the release of the seventh edition, the program has enlisted its international faculty and expanded its materials and course options. This edition features updated and revised texts, as well as a new course. A military version of the Tactical Combat Casualty Care course has been rolled out over the past year and a half.
The Revision Process
The seventh edition revision began by incorporating changes from the eighth edition of the Advanced Trauma Life Support textbook, which provides the basis for PHTLS. To the fullest extent possible, the revision was based on evidence, demonstrating the science behind PHTLS, incorporating data from new clinical research on trauma care in the prehospital setting and using position papers as appropriate from national EMS organizations, such as the National Association of EMS Physicians.
The text focuses on principles—not preferences—to equip EMS providers with the knowledge base to make reasonable patient care decisions.
Although there’s no official PHTLS way to perform each skill included in the text, the principle for each is explained and illustrations of how to perform one acceptable method of each skill are included in the textbook and companion videos.
The book is organized into logical sections that allow readers and faculty to easily locate the information they need. All chapters have been edited and updated to reflect current statistics. In some cases, additional references were added, as well as new scenarios, illustrations, photos and algorithms, which were revised to reflect changes.
Throughout the text, the authors sought to maintain consistency between chapters in terms of terminology, assessment and management. Assessment sections follow the primary survey (A-B-C-D-E) approach. Metric weights and measures are included for international readers, and the term prehospital care provider is used to describe the variety of PHTLS providers at work all over the program’s international network.
A new chapter in this edition, “The Art and Science of Prehospital Care,” is a discussion of principles, preferences and critical thinking in EMS. This chapter describes principles—those things that must be present, accomplished or ensured by healthcare providers to optimize the chances of patient survival and outcomes—and discusses preferences (i.e., the various ways these principles can be implemented from system to system).
In the critical thinking section, authors explain prehospital trauma care assessment and reassessment, and they caution readers against letting biases affect their critical thinking skills.
The civilian tactical EMS (TEMS) chapter was completely revised to reflect current practices and threats, and to describe the history of TEMS. A companion DVD included with the text demonstrates 29 separate skills.
PHTLS Provider Course
The seventh edition brings with it the most extensive revision of the PHTLS provider and refresher courses. Based on feedback from PHTLS faculty all over the world, the lectures were rewritten to emphasize the airway, breathing, circulation (ABC) approach to patient care. The skill stations were redesigned to provide the opportunity to practice assessment and skills, and they provide teachable moments while working in moulage patient scenarios.
Dozens of scenarios are included in the instructor materials, which were submitted from faculty in every country where PHTLS is active. So far, feedback from faculty and students has been enthusiastic, and more scenarios will soon be available to enhance the course’s flexibility. The refresher course was also completely rewritten to follow this format.
Trauma First Response Text
PHTLS has also added a new member to its family of texts and courses with Trauma First Response. This text is a smaller version of the PHTLS seventh edition, edited specifically to be appropriate for EMS providers or first responders with little or no medical training who may be called on to care for a trauma patient. The audience for this text and course ranges from trained responders, such as police officers and firefighters, to factory personnel, teachers or anyone else who may be called on to care for the injured.
Overall, the course is designed to teach the principles of PHTLS to those first called to care for patients and prepare them to care for trauma patients while awaiting transport or serving as part of the transport team. The program stresses the core PHTLS principles to those who don’t have an EMS background or advanced prehospital training. It’s a one-day (eight-hour) course by design, but it can be scheduled to accommodate the needs of students and faculty. It’s approved for Continuing Education Coordinating Board for EMS (CECBEMS) credit for licensed or certified EMS providers.
Tactical Combat Casualty Care
The military version of the seventh edition was revised by members of the
Tactical Combat Casualty Care committee, and it’s the text for the PHTLS Tactical Combat Casualty Care course, which is being introduced in the U.S., Europe and South America. PowerPoint presentations for this course are updated quarterly, and supporting materials are also available on the PHTLS website.
Scheduled for release in coming weeks is an online version of PHTLS, designed to work in conjunction with skills and testing at a course site or as a standalone continuing education course. Elsevier and the National Association of Emergency Medical Technicians will be making details public soon, and we demonstrated the program in development at the 2011 EMS Today Conference & Expo in March.
The PHTLS seventh edition has many new things to offer to trauma care educators, and more developments will be coming soon as PHTLS continues to explore potential e-learning opportunities. JEMS
This article originally appeared in April 2011 JEMS as “Trauma Care Revisited: PHTLS 7th edition offers new training materials.”