Legislation, CPR, Risky Business and ATLS

Trauma Funding Legislation
Trauma legislation made the news in the last month. Congress approved a bill to increase funding to create and expand trauma systems. This bill is a renewal and expansion of funding that first appeared in 1990. This support has resulted in $30 million being provided in support of trauma care. The bill approved last month doubles the funding from $6 million to $12 million, running through fiscal year 2012.

Some of the things the funding is designed to support specifically include:

  • Creation of a model curriculum for first responders, EMS personnel, nurses and physicians;
  • Public and Private research and development projects;
  • Increasing trauma center capacity and coordination;
  • Improving data systems; and
  • Enhancing emergency preparedness.

While this is not a trauma topic necessarily, it caught my attention. The journal, Lancet from the United Kingdom recently published a study that would seem to promote compression-only CPR. The article describes the importance of the findings, given the reluctance of bystanders to perform mouth-to-mouth ventilations.

In this study, Japanese researchers looked at data from 4,068 patients. Of these, 18% received CPR according to standards, 72% had no treatment and 11% had compressions only. At the end of the day, the patients who got something universally did better than the patients who got nothing. What was striking about the report is that they found no significant difference in outcomes between the patients who got compression-only and the ones who got conventional CPR with ventilations.

Repeating trauma patients have high risk behaviors in common
While it comes as no surprise to those of us who have worked in trauma in any one place for any length of time, a recent study published in the March edition of the Journal of Medicine reports that repeat trauma patients generally have high risk life styles, including substance abuse. The study was done at the University of Texas Southwestern Medical Center and looked at 161 patients over eight years. Among the findings were:

  • 72 of the 161 patients returned for another traumatic injury;
  • Substances abusers were more likely to return for another trauma event;
  • 44% of all cases were related to fighting; and
  • More than 70% of the patients had arrest records.

Pretty much since the course first began 30 years ago, EMS providers and educators have been trying to get their hands on Advanced Trauma Life Support textbooks. The American College of Surgeons restricted the book to course participants only. That all will change on or before May 1 when the ATLS seventh edition student manual becomes available for sale to individuals outside of the course.

The ATLS Subcommittee of the Committee on Trauma of the American College of Surgeons voted to make the text available in response to innumerable requests they ve received over the years. The book will be available for purchase for $80. from the ACS COT Publications Web-page by May 1. Once the link is installed, you will find it at www.facs.org/trauma/publications.html.

There will be a brief survey that the ATLS staff would like you to fill out that will enable them to get a look at the interest in the ATLS text.

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