Emergency Services Times 14.3_– 27/06/2013 15:12 Page 55
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ATACC – an integrated approach to trauma care It is dark and raining as your six-person, multi-agency team, respond to a serious RTC entrapment, following a police firearms incident in a local scrap yard. The firearms team declare it safe to enter the scene to manage the seriously injured casualties. The gunman is pinned against heavy railings by a car and is screaming in pain and bleeding out rapidly from two large thigh wounds, over his broken legs. The driver is conscious, with a gunshot wound to the neck, which is bleeding very heavily from a major artery, and his passenger has a gunshot wound to the chest and is barely breathing. The team rapidly takes in the scene and under the direction of the Lead Medic, begin to manage each casualty simultaneously. All three could die on scene, but with the skills of the firefighter, police firearms officer, paramedic and doctors working together they could save them all. Words: Dr Mark Forrest, Medical Director, Cheshire Fire and Rescue Service & ATACC Faculty Medical Director. This sounds like the latest Bruce Willis Blockbuster or your worst nightmare, but this is actually a typical advanced trauma simulation for candidates on the ATACC (anaesthesia, trauma and critical care) course, which after 15 years still remains the most up to date and advanced trauma course available in the UK. A recent Royal College of Surgeons assessor admitted that he was unsure about the benefits of combining firefighters, police officers, para-medical and medical staff together in teams on the course. What would an orthopaedic surgeon get from a tactical scenario or what can a firefighter bring to a complex hospital resuscitation room trauma scenario? However, once he saw how the team develops and builds through human factors, knowledge, technical skills and command and how they become a far more effective ‘trauma team’, he commended the Faculty on this unique approach.
scenario complexity rises until ultimately major poly trauma seems far less daunting when approached in a systematic fashion. Specialist modules The Rescue Trauma & Critical Care (RTACC) is the BTACC course with Specialist modules, eg Haemostatics, traction splints, Entonox, RSI assist, crush and suspension trauma etc. While the ATACC course is entirely trauma based, both BTACC and RTACC include resuscitation and medical emergency modules. firefighters. That same year Cheshire won the UKRO Trauma Challenge and opened a new standard of Fire & Rescue Trauma Care as defined in the CFOA Immediate Emergency Care (IEC) standard. Police standard BTACC also meets the Police NOIA D13/D13E standard for Tactical Firearms and has been adopted by Greater Manchester, Lancashire, Merseyside and soon potentially all police firearms teams in the north west. There is no unnecessary anatomy and physiology but a highly effective course, which teaches that the simple things, done well, saves lives!
Considerable benefits Benefits are considerable for everyone. Candidates develop excellent team skills, they can adopt in the operating theatre or pre-hospital environment. They also share knowledge, and their combined years of experience, and by the end of the course they make formidable teams. ATACC is a highly demanding course for those with considerable trauma experience but numerous emergency services and other agencies are now adopting the less advanced but highly focused elements of the three level ATACC Integrated Trauma Course (ITC). Cheshire Fire and Rescue Service was the first to adopt the BTACC (Basic Trauma and Casualty Care course) as a more appropriate and advanced alternative to First Aid at Work for all operational
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“As a team develops and builds through human factors, knowledge, technical skills and command they become a far more effective ‘trauma team’.” Short powerful lectures are alternated with skill stations and simulated scenarios in realistic environments. Casualty simulation with live actors is kept simple yet graphic to maximise the effect and enhance the learning experience. As each element of the course is introduced the next
By the end of a BTACC course, candidates will be able to manage all major traumatic injuries such as a fall from height with head, chest, pelvic and spinal injuries and potential internal bleeding. The course gives them the confidence to approach, assess, manage and then package such patients rapidly, safely and effectively, ready to hand over to paramedics. www.cheshirefire.gov.uk
About ATACC ATACC is a non-profit commercial course, while BTACC and RTACC are delivered by the company Promedsol, or emergency service instructors, who have completed Promedsol instructor training. Interested parties can contact Mark at ATACC atacc.doc@btinternet.com or through Cheshire Fire and Rescue Service: mark.forrest@cheshirefire.gov.uk
Emergency Services Times June 2013