Advanced trauma life support prolongs patients' lives until specialist help arrives

EDITOR—At the end of his second paragraph Tice states: “Full training in advanced trauma life support for all accident and emergency doctors may lead to complacency and a reluctance to involve other specialties early.”1 The provider course for advanced trauma life support lays great emphasis on obtaining specialist help early in the management of injured patients (advanced trauma life support course, 6th edition). Trained doctors would be expected to anticipate this need from the history and mechanism of injury, and should life threatening or potentially life threatening injuries become apparent during treatment then specialist help would be summoned immediately if not already present.

Training in advanced trauma life support has never been promoted as an opportunity for teaching skills to specialist levels, but it does provide a vital structure of basic skills which allows the patient's life to be prolonged until specialist help arrives. Additionally, it acts as a common framework from which all staff can work successfully.

Priority of place should be given to those exposed to the management of seriously injured patients. This should include the third of senior house officers who take up a position in accident and emergency medicine but who have no intention of staying in this specialty. They also need skills in advanced trauma life support to manage patients safely.