You are on page 1of 15

8/14/2013

2013
Faculty Update

Objectives

ATCN 2013
Faculty Update

Overview of critical content revisions 9th Ed. ATLS


Review ATCN 2013 edition

Student Manual
Skill Station Revisions
Faculty Manual
Triage Scenarios
Initial Assessment Scenarios
Written Exams

ATCN P&P Updates

ATCN 2013 Faculty Update

8/14/2013

ATCN 2013
Faculty Update

9th Ed. ATLS Student Course


All faculty need to have access to new ATLS
text.
There are many updates and revisions
throughout all chapters.
Faculty should re-read the ATLS text to
become familiar with the many updates.
Faculty should attend their skill station
ATLS lecture.
Yes, even if you have been teaching for years
the ATLS slides have changed and the content
that is taught/emphasized may be different.

ATCN 2013 Faculty Update

ATCN 2013
Faculty Update
Major ATLS Content Updates
Initial Assessment

In many centers, trauma patients are assessed by a


team, the size and composition of which varies
from institution to institution. In order to perform
effectively, one team member should assume the
role of team leader. The team leader supervises the
preparation for the patients arrival, the
assessment, treatment and transfer of the patient.

ATCN 2013 Faculty Update

8/14/2013

ATCN 2013
Faculty Update

Major ATLS Content Updates


Airway

Previous concerns about cuffed endotracheal tubes


causing tracheal necrosis are no longer relevant due to
improvements in the design of the cuffs. Ideally, cuff
pressure should be measured as soon as it is feasible
and, 30mm Hg is considered safe.
Alternative intubation devices have been developed over
the years with the integration of video and optic imaging
techniques. Their use in trauma patients may be
beneficial in specific cases by experienced providers.
Careful assessment of the situation, equipment, and
personnel available is mandatory, and rescue plans must
be available.

ATCN 2013 Faculty Update

ATCN 2013
Faculty Update
Major ATLS Content Updates
Shock

Hypertonic saline has no benefit over standard


crystalloid resuscitation.
The concept of balanced resuscitation is further
emphasized, and the term aggressive resuscitation has
been eliminated. The standard use of 2 liters of
crystalloid resuscitation as the starting point for all
resuscitation has been modified to initiation of 1 liter of
crystalloid. Early use of blood and blood products for
patients in shock is also emphasized, without mandating
or suggesting any specific ratio of plasma and platelets

ATCN 2013 Faculty Update

8/14/2013

ATCN 2013
Faculty Update
Major ATLS Content Updates
Abdomen/Pelvis

Reemphasized title Abdomen and Pelvis to


delineate pelvis as under-recognized source of
hemorrhagic shock.
All pelvic content moved to Abdomen and Pelvis
chapter

ATCN 2013 Faculty Update

ATCN 2013
Faculty Update
Major ATLS Content Updates
Pediatric

Previous concerns about cuffed endotracheal tubes


causing tracheal necrosis are no longer relevant due
to improvements in the design of the cuffs. Ideally,
cuff pressure should be measured as soon as it is
feasible and ,30mm Hg is considered safe.

ATCN 2013 Faculty Update

8/14/2013

ATCN 2013
Faculty Update
Major ATLS Content Updates
Optional skills for ATLS students
DPL
Pericardiocentesis

ATCN 2013 Faculty Update

ATCN 2013
Faculty Update
2013 Student Manual Revisions

6 Skill station workgroups reviewed content and recommended


revisions
International focus, > 40 faculty from 8 Countries and the US

ATCN Student & Faculty Manual Format Revisions.

References are only listed if not listed as a reference in ATLS text.


Selected terms and abbreviations updated for international consistency.
Double side page printing, two color.
New outline format for all text.
New Side Bar
Student Manual

Cautions: highlight situations/issues that may lead to patient harm


Notes: additional information to supplement the main text

Faculty Pearl: Highlights an opportunity to facilitate a discussion or emphasis an


idea
Note: additional information to supplement the main text

Faculty Manual

ATCN 2013 Faculty Update

8/14/2013

ATCN 2013
Faculty Update

New
Cover
Graphics!

ATCN 2013 Faculty Update

ATCN 2013
Faculty Update

New Layout and


Format for
Student &
Faculty Manuals

ATCN 2013 Faculty Update

8/14/2013

ATCN 2013
Faculty Update

ATCN Skill Station Updates


Updated table top information cards
Equipment lists updated
Airway

Surgical airway tray or representation of this


(optional)

Head

Helmet optional

Musculoskeletal

Long backboard deleted. Tourniquets added

ATCN 2013 Faculty Update

ATCN 2013
Faculty Update
Equipment Changes

Initial Assessment

Airway

Shock

Head

Musculoskeletal

Pediatric

- Delete Intubating LMA


+ Add Tongue Blades
+ Add End tidal CO2 device (optional)
+ Add Surgical Airway tray (optional)

Remember:
Write-on
Board for each
station

No changes
- Delete Helmet (optional)
- Delete Long backboard
+ Add Pelvic Stabilizing Device / Sheet
+ Add Tourniquet
+ Add Pediatric Chest Tubes
+ Add Towel or Blanket
(Used to align head/body on backboard)

ATCN 2013 Faculty Update

8/14/2013

ATCN 2013
Faculty Update

Initial Assessment

Student Manual

Faculty Manual

Standardized format for


EMS report.

No change to the
general content or
format

Specific guidance to
faculty on responses to
students assessments

Integration of increased
emphasis on balanced
resuscitation

If student uses a LEMON


assessment during airway, the
LEMON parameters are
provided for the faculty to
give to the student.

Emphasis on pericardial
tamponade and tension
pneumothorax
identification.

Pearls to remind faculty


to emphasize selected
discussion topics. (i.e.
difference between
Tension PTX and Cardiac
Tamponade.)

ATCN 2013 Faculty Update

ATCN 2013
Faculty Update
Student Manual

No change to the general


content or format
Improved graphics
(larger and clearer
images)
Selected lab values (i.e.
PaCO2) identical to those
referenced in the ATLS
text.

Airway
Faculty Manual

Standardized format for


EMS report.
Specific guidance to
faculty on responses to
students assessments
If student uses a LEMON
assessment during airway, the
LEMON parameters are
provided for the faculty to
give to the student.

Pearls to remind faculty


to emphasize selected
discussion topics. (i.e.
importance of needle
placement for treatment
of tension PTX.)

ATCN 2013 Faculty Update

8/14/2013

ATCN 2013
Faculty Update

Shock

Student Manual

Faculty Manual

No change to the general


content or format

Standardized format for EMS


report.

Improved graphics (larger


and clearer images)

Specific guidance to faculty


on responses to students
assessments

Emphasis on balanced
resuscitation
New sections on Nonhemorrhagic shock
conditions (i.e. cardiac
tamponade, neurogenic
shock, etc.)

Changes to vital signs during


scenario. **Faculty should use

their judgment to give the


student a clinically accurate
picture based on the
assessments and interventions
selected by the student

Pearls to remind faculty to


emphasize selected
discussion topics. (i.e. if the
student asks for an ABG,
discuss the relevance and
importance of the
results)

ATCN 2013 Faculty Update

ATCN 2013
Faculty Update

Head

Student Manual

Faculty Manual

Helmet removal no
longer taught as a
skill.

Helmet removal no longer


a skill, however, faculty
have the option to discuss
principles of helmet
removal as appropriate
for each student class.

Improved graphics
(larger and clearer
images)

Pearls to remind faculty


to emphasize selected
discussion topics. (i.e. if
the student asks for an
ABG, discuss the
relevance and importance
of the results)

ATCN 2013 Faculty Update

8/14/2013

ATCN 2013
Faculty Update

Musculoskeletal

Student Manual

Faculty Manual

Securing patient to long


spine board no longer
taught as a skill. Application
C-collar and principles of
spinal immobilization
(logrolling) are still taught.
Increased emphasis on
extremity neurovascular
assessments.
Emphasis on skills for
immobilization of fractured
pelvis.

ATCN 2013 Faculty Update

Placing patient on, and securing to, a long


spine board, is no longer taught.

C-collar application and principles of


logrolling are still taught.

Case scenarios revised

I- collar application and logrolling


II-Neurogenic vs. spinal shock
III-Pelvic fracture immobilization
IV-Tourniquets, Compartment syndrome

Note: Case II is a neurogenic shock


scenario, NOT a spinal shock scenario.
Faculty with early print editions should note
this on pg. 60 of their faculty manual.

Additional 4th case scenario will make time


management especially important.

Faculty need to review/learn proper hands


on skills for pelvic immobilization based on
the equipment use in their region.

Pearls to remind faculty to


emphasize selected discussion
topics.

ATCN 2013
Faculty Update
Student Manual
No change to the general content or
format.
Use of cuffed ETT now taught.
Use of Atropine during intubation is
for patients 1 y/o or less.
Expanded emphasis on airway
assessment and interventions.
Introduction of mnemonic DOPE for
troubleshooting airway problems.

Dislodgement
Obstruction
Pneumothorax
Equipment failure

Pediatric
Faculty Manual

Standardized format for EMS


report.
Specific guidance to faculty on
responses to students
assessments
Pearls to remind faculty to
emphasize selected discussion
topics.
Note: ATLS text inconsistencies.
Pg. 253, midazolam doses in

figure 10-3 differ from those


referenced in text below, faculty
should review reasons for this
difference.
Pg. 256, calculation for weight
listed as 2x age +10. ATCN table
top card uses 2x age +8.

ATCN 2013 Faculty Update

10

8/14/2013

ATCN 2013
Faculty Update
Triage Scenario Review

Triage Scenarios printed in ATLS student


manual.
Combined ATLS/ATCN Triage Scenario review
is encouraged (and supported by the ACS!)
If combined review is not possible
ATCN is permitted to use ATLS scenarios
independently

Faculty answers, ATLS Faculty Manual (section 2,


appendix J)

New ATCN Triage Scenarios will be available for use


at the discretion of Course Director
ATCN 2013 Faculty Update

ATCN 2013 Faculty Update

11

8/14/2013

ATCN 2013
Faculty Update

New ATCN Website! www.atcnnurses.org

General access pages for all faculty

Secure access pages for Course Directors


Written exams, Initial assessment scenarios.

Links to trauma educational resources.

ATCN 2013 Faculty Update

ATCN 2013 Faculty Update

12

8/14/2013

ATCN 2013 Faculty Update

New written exam questions


cross-reference with ATLS
and ATCN texts. Available on
Course Director web page

ATCN 2013 Faculty Update

13

8/14/2013

Written exam question


analysis tool

ATCN 2013 Faculty Update

Initial Assessment Scenario


analysis tool

ATCN 2013 Faculty Update

14

8/14/2013

ATCN 2013
Faculty Update
ATCN Policy & Procedures Update
New Format
New P&Ps

Live Video Conference Option


1 day ATCN Refresher Course
Student Course options for APNs who have taken
ATLS

ATCN 2013 Faculty Update

ATCN 2013
Faculty Update

ATCN 2013 Faculty Update

15

You might also like