Pediatricians and the advanced trauma life support (ATLS((R))): Time for reconsideration?

Background: General pediatricians in Israel are actively involved in the in itial evaluation, resuscitation and management of traumatized children. How ever, pediatric trauma care is not a part of pediatric specialty training i n Israel, and the few Advanced Trauma Life Support(R) courses per year are insufficient for most pediatricians working in accident and emergency care. Objective: To examine the value of the course in relation to the limited re sources available for such training. Methods: A telephone survey of 115 pediatricians who had taken the course b etween 1990 and 1994 was conducted. The responding physicians (67%) were as ked to complete a specially designed questionnaire on life saving procedure s that were taught in the course. In addition, they were asked to subjectiv ely assess the practical utility of the course. Results: Forty-three (56%) pediatricians reported that they routinely treat ed both adult and pediatric trauma cases. Of these, 81% performed 27 life-s aving ATLS(R) procedures. Pediatric trauma was treated by only 22 (28%), of whom 72.3% performed 18 life-saving ATLS(R) procedures. These pediatrician s ranked the courses as being "very high" to "high" in impact. Conclusions: These figures indicate that an ATLS(R) course designed specifi cally for pediatricians can markedly improve pediatric trauma care. To ensu re standard education and patient care, such a course should be developed a nd made a mandatory component of residency training. Further studies to exa mine the objective impact of the courses on pediatric trauma care should be carried out.