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The European Trauma Course: Trauma Teaching goes European

Article  in  European Journal of Trauma and Emergency Surgery · August 2013

DOI: 10.1007/s00068-013-0317-z

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Eur J Trauma Emerg Surg
DOI 10.1007/s00068-013-0317-z

EDITORIAL

The European trauma course: trauma teaching goes European

K.-C. Thies • C. D. Deakin • P. M. Rommens • E. J. Voiglio • M. B. Sabbe •

R. Arafat • G. Brattebø • F. K. Lippert • C. Lott • D. Robinson

Received: 4 July 2013 / Accepted: 24 July 2013

Ó Springer-Verlag Berlin Heidelberg 2013

The World Health Organization (WHO) has identified decreased by a further 30 % by improving the chain of care
trauma as the major health care challenge of our century, for major trauma patients [2].
claiming more productive life years worldwide than any Crucial links in this chain are effective hospital trauma
other disease [1]. In the European Union (EU), injury teams responsible for the initial assessment and manage-
accounts for 15 % of all deaths before the age of 60 years ment of trauma patients. The concept of trauma teams is
and is the fourth most common cause of death, with more well established in most European countries, requiring
than 235,000 deaths each year from injuries, equating to different medical specialties and non-medical professions
600 injury fatalities per day [2]. In children, adolescents to work seamlessly together under significant time pres-
and young adults, accident and injury rates are even higher, sures in order to achieve the best possible patient outcome.
being the leading cause of death in these age groups. The main attributes of successful trauma teams are com-
Mortality from trauma in the EU has fallen 20 % in the petent team members, leadership, excellent communication
past 20 years, to a rate of 63.7 per 100,000 in 2010 [3]. and cooperation [4, 5]. The unmet need for a corresponding
This reduction is partly due to primary injury prevention, training programme has prompted the European Resusci-
but indicates a significant contribution of improved emer- tation Council (ERC) to launch the European Trauma
gency health care services. Despite improvements in both Course (ETC) project in cooperation with the European
primary and secondary injury prevention, the WHO esti- Society of Anaesthesiology (ESA), the European Society
mate that the mortality of major trauma in Europe could be for Trauma and Emergency Surgery (ESTES) and the
European Society for Emergency Medicine (EuSEM). An
international group of clinical experts in trauma care and
All authors are board members of the European Trauma Course medical education was appointed to develop the course
Organisation.
and, after 3 years of developmental work and four pilot
K.-C. Thies (&)
G. Brattebø courses, the first ETC was held at the 2008 ERC meeting in
European Society of Anaesthesiology, Brussels, Belgium Ghent, Belgium.
e-mail: kcthies@hotmail.com The ETC is an innovative, multi-disciplinary 2.5-day
course aimed at doctors and allied health care professionals
C. D. Deakin
F. K. Lippert
European Resuscitation Council, Antwerp, Belgium involved in the initial care of severely injured patients. The
novel modular course concept is scenario-based and pro-
P. M. Rommens
E. J. Voiglio vides state-of-the art team training through workshops and
European Society for Trauma and Emergency Surgery,
skill stations, reflecting prevailing European practice.
Vienna, Austria
Twenty-four candidates, in teams of four (doctors from all
M. B. Sabbe
R. Arafat specialties, nurses, paramedics), are taken through 30
European Society for Emergency Medicine, London, UK progressive trauma admission scenarios, with a strong
focus on teamwork, communication and non-technical
C. Lott
D. Robinson
ETC Course Management Committee, c/o ERC, Antwerp, skills. The modules cover all major aspects of trauma
Belgium resuscitation. Two lectures and two patient demonstrations

123
 K.-C. Thies et al.

complement the course, keeping didactic teaching to a international charity registered in Belgium, hosted by the
minimum. Candidate assessment is performed continu- ERC. The main goals of the ETCO are further develop-
ously as well as in a summative way at the end of the ment, quality control and the international implementation
course. of the ETC.
For workshops, the candidates are grouped in teams of We believe that the unparalleled success of this course is
four and assume the roles of a trauma team leader and team due to its focus on teamwork, communication and non-
members. The roles are rotated amongst candidates after technical skills, together with its emphasis on practical
each scenario, giving all participants the opportunity to rather than didactic teaching. It is likely to see further rapid
understand and practice each function within a trauma uptake across Europe, where we hope to see it established
team. Two instructors guide each workshop. as a key requirement for health care teams involved in the
The first day of the course focuses mainly on identifying initial management of severely injured patients, thereby
and treating immediately life-threatening airway, breathing contributing to the WHO goals of further reducing avoid-
or circulatory trauma conditions during a primary survey. able deaths from trauma.
On the second day, the participants deal with assessments of
the whole body (secondary survey), specific body areas (e.g. Conflict of interest None.
abdomen, head, spine), and special patients (e.g. paediat-
rics, pregnancy). On the final day, the summative assess-
References
ment takes place. All candidates are required to successfully
complete at least one scenario as a team leader. 1. Global Forum on Trauma Care. World Health Organization
Since its launch in 2008, the programme has grown (WHO), Rio de Janeiro, Brazil, 28–29 October 2009.
exponentially; more than 2,000 doctors and allied health 2. Injuries in the European Union. Summary 2002–2004. http://ec.europa.
care professionals now having been trained. There are 65 eu/health/archive/ph_determinants/environment/ipp/documents/
injurieseu_sum_en.pdf.
European courses for 1,560 candidates planned for 2013 3. The European health report. http://www.euro.who.int/__data/
alone. The publication of the re-written third edition of the assets/pdf_file/0003/184161/The-European-Health-Report-2012,-
course manual is scheduled for November 2013. The great FULL-REPORT-w-cover.pdf.
success of the ETC programme has encouraged the four 4. Østergaard HT, Østergaard D, Lippert A. Implementation of team
training in medical education in Denmark. Qual Saf Health Care.
partner organisations to further formalise their cooperation 2004;13:i91–5.
and to set up the European Trauma Course Organisation 5. Berlin JM, Carlström ED. The 20-minute team—a critical case
(ETCO) to take on the management and further develop- study from the emergency room. J Eval Clin Pract. 2008;14:
ment of the ETC programme. The ETCO is now an 569–76.

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