Identification of trauma as a major cause of morbidity and mortality i
n Trinidad and Tobago prompted the establishment of a training program
me aimed at improving trauma care in this developing country. An Advan
ced Trauma Life Support (ATLS) programme for physicians funded through
the Canadian International Development Agency resulted in a statistic
ally significant improvement of in-hospital trauma patient outcome at
the Port-of-Spain General Hospital (observed to expected mortality rat
io of 3.16 pre-ATLS compared to 1.94 post-ATLS). A recent analysis of
all motor vehicle injuries for a shorter period did not confirm this p
ositive impact of the ATLS programme, primarily because a large number
of these patients died in the pre-hospital period Pre-hospital trauma
care therefore required urgent attention to complement the positive i
n-hospital impact of the ATLS programme. A second training programme (
the Pre-Hospital Trauma Life Support or PHTLS) for paramedical personn
el was thus instituted in 1990. Over 250 physicians have been trained
in the ATLS programme and to date over 100 paramedical personnel have
been trained in the PHTLS programme. Attempts have also been made to e
quip the ambulances with more appropriate resuscitative devices in ord
er to improve pre-hospital care. The combination of the PHTLS and the
ATLS programme should result in further improvement in the care of pat
ients sustaining major injuries in Trinidad and Tobago.