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World Journal of Surgery
Published in: World Journal of Surgery 8/2015

01-08-2015 | Original Scientific Report

Level of Evidence Analysis for the Latest German National Guideline on Treatment of Patients with Severe and Multiple Injuries and ATLS

Authors: Matthias Münzberg, Manuel Mutschler, Thomas Paffrath, Heiko Trentzsch, Arasch Wafaisade, Felix Walcher, Marcus Raum, Sascha Flohé, Christoph Wölfl

Published in: World Journal of Surgery | Issue 8/2015

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Abstract

Purpose

Advanced Trauma Life Support (ATLS®) is one of the world’s best-known training programs for medical providers. Revisions of the ATLS manual have been evidence based for a number of years. In 2011, a level 3 (S3) evidence- and consensus-based guideline on the treatment of patients with severe and multiple injuries was published in Germany. The scope of this study was the systematic comparison of the educational content of the ATLS concept and the interdisciplinary “S3 polytrauma guideline.”

Methods

A total of 123 key recommendations of the guideline were compared with the content of the ATLS manual (9th edition). Depending on the level of agreement, the recommendations were classed in the following categories: (1) Agreement. (2) Minor variation. (3) Major variation.

Results

An overall 86 % conformity was found between the key recommendations of the guideline and the ATLS® manual. The ATLS® primary survey (ABCDE) showed an 85 % conformity. The degree of conformity for the individual priorities was as follows: A (Airway) 79 %, B (Breathing) 79 %, C (Circulation) 86 %, D (Disability) 93 %, E (Exposure) 100 %. The ATLS® secondary survey showed a 94 % conformity. The main differences were in the areas of anesthetic induction, fluid administration, and coagulation therapy.

Conclusions

According to our comparison, the educational content and manual of the ATLS are largely compatible with a high level of evidence S3 guideline. However, subsequent editions of both the ATLS® and the S3 guideline should re-examine and reassess a number of aspects.
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Metadata
Title
Level of Evidence Analysis for the Latest German National Guideline on Treatment of Patients with Severe and Multiple Injuries and ATLS
Authors
Matthias Münzberg
Manuel Mutschler
Thomas Paffrath
Heiko Trentzsch
Arasch Wafaisade
Felix Walcher
Marcus Raum
Sascha Flohé
Christoph Wölfl
Publication date
01-08-2015
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 8/2015
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-015-3063-z

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