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Wed Feb 23 18:24:37 GMT 2011

Dear Doc Holiday,

I was wondering if it would be possible to get a list of the references you
talk about in this post, I'd be really grateful!
Thanks,
Tom Riley
ACCS CT1
(Did ATLS as an F2 :-))

On 22 February 2011 23:50, Doc Holiday <drydok at hotmail.com> wrote:

>
> From: atacc.doc at btinternet.com
> > This is all well and good and I certainly loved teaching ATLS for many
> years, until I realised that much of it was wrong!
>
> --> Yup. That's the thing with textbooks...
>
> Luckily for ATLS, it's only a book and a course. An educational tool. No
> more.
>
> > The course has certainly improved since my early days
>
> --> As we have also seen other aspects of EM improve.
>
> One fun thing to try, after a few beers, is to sit in a group and read an
> old EM textbook from when we were in Medical school. Some really funny stuff
> in there that we use to swear by.
>
> > but it is still far from perfect
>
> --> And OBVIOUSLY so! Which, in a funny way, can be turned into one of its
> strengths. It is so obvious that some of the details are wrong that students
> immediately accept that when the instructor shows them that he accepts it
> and one can then move on to instill the principles, the attitude, the search
> for pitfalls, the systematic approach, the million other things which are
> still valid.
>
> > ...instills some deeply ingrained bad habits in trainees
>
> --> I find that a careful reminder to all participants of it being a
> changeable text, showing them how it is revised, including in discussions or
> at other opportunities the references to and the latest relevant evidence on
> fluids or whatever and the bad habits can be avoided.
>
> Another thing I think you'll agree with - one may well find worse habits in
> someone who's not even got as far as ATLS!
>
> And another - for every "fact" which is now known "wrong" in ATLS, there
> are in it quite a few more which are still right ;-) And, judging by other
> aspects of modern medicine, some things which have been shown to be wrong
> may well end up being later shown to be right again...
>
> > Those of us that now have more than a few grey hairs...
>
> --> I have those... I call them "marriage highlights"... When the wifey is
> out of earshot...
>
> > can see the good in many aspects of ATLS and the systems that it
> establishes
>
> --> Agree 100%. And there are enough of those to stuff full a 3-day course.
> We identify the best in the text and aim to build it up for the whole
> course.
>
> > sadly too many of our colleagues and even our trainees view it as Gospel
> and the definitive word
>
> --> A danger with any text. I guess that's why one's not supposed to get
> hands on the book without the course an lucky that these days spaces on
> courses are so easy to come by that anyone who wants to go on one can have a
> place.
>
> > ATLS has to be the standard for all involved, but for anything more
> individuals need to seek out...
>
> --> One good trick is to have these references for them AT THE COURSE and
> point out to them which bits of "data" are currently considered out of date
> and which bits they really should read up on.
>
> > sadly many won't seek out such training and will sit back on ATLS
>
> --> True. These docs to whom you refer do exist and they make few efforts
> to look beyond anything which does not get spoon-fed to them... Which means
> they are likely to have minimal useful knowledge anyway... So I guess at
> least they have ATLS! These non-seekers are exactly that breed of doctor for
> whom ATLS is still just about "Advanced", as they tend to read little
> otherwise...
>
> > For trauma leaders...we need real evidence of ongoing CPD and an
> enthusiasm to attend some of the numerous other smaller but more advanced
> courses available
>
> --> Right. AND for leaders in other subjects, e.g. reading beyond
> ALS/ACLS...
>  --
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>

-- 
Thomas Riley
Mob.  07854019763
Tel.    02088158024
e-mail. tom at tomriley.co.uk

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