Advanced trauma life support course for medical students. A new era?

Introduction: Trauma represents a major public health issue and is one of the leading causes of death and disability worldwide. A systematic approach toward dealing with trauma patients was facilitated through the ATLS program, which has become a milestone in trauma care. Our new ATLS course for medical students was set in motion in 2015. Our aim was to make medical students familiar with trauma patients interactively, through a program like ATLS, and here we present the results of this endeavor. Methods: A two-day ATLS-Medical Student (MS) course was offered from November 2015 to July 2018, and analysis was performed retrospectively on the data gathered over a three-month period through online questionnaires. Before graduating, 261 newly qualified medical doctors were interviewed and evaluated as part of the ATLS course. Results: After the course, the vast majority of medical students (251 MSs; 96.16%) felt more capable of managing severely injured patients and 58% of students felt that the medical services they offered were better due to the ATLS training. Regarding the educational fee for the course, 56.7% of the students reported that they felt the fee of 100 euros was fair. Discussion: The interactive format of the course, which differs from more traditional methods of teaching, has been endorsed by medical students. Though they lack clinical experience, that does not prohibit them from acquiring more specialized or specific knowledge, enabling them to excel. Most of the students improved their skillset either in theoretical knowledge, practical skills, or even in the emotional component of the course, i.e., dealing with treating a severely injured patient. It was decided that the program would be re-evaluated and extended to all Greek Medical Schools. Conclusion: The advantage of providing doctors with trauma training at the beginning of their careers is evident. For that reason, it was decided that the program would be re-evaluated and extended to all Greek Medical Schools.

Spontaneous pneumothorax. When and how to treat.

INTRODUCTION: Spontaneous pneumothorax, whether primary or secondary, may occur in patients with or without a history of pneumonic disease. AIM OF THE STUDY: From 1992 to 2002, we treated 275 patients, 230 male and 45 female, in the department of Thoracic Surgery of the General Hospital of Nikaia-Piraeus. In this study the Authors report the data concerning the frequency correlated with age, sex, causes, symptoms, as well as the ways of treatment, in order to compare them and their results with those recorded in Greek and international literature. CONCLUSIONS: It is made obvious by our material that only approximately 10% of patients suffering from spontaneous pneumothorax need surgery (thoracotomy), while the remaining patients can be managed with closed thoracic drainage or conservative treatment and monitoring.

Sternal fracture with or without associated injuries. Assessment of the difference in the diagnosis, management and complications. Eighteen years of experience.

AIM OF THE STUDY: To determine the incidence of sternal fracture as an isolated injury as well as those which presented with concomitant injuries, and compare them in order to manage them more effectively. The Greek and International Literature related to the subject was also reviewed. MATERIAL AND METHODS: From 1984 to 2002 the Authors treated 134 patients with sternal fracture in the Department of Thoracic Surgery of their hospital, 59 males and 45 females, age from 17 to 84 years. Ninety patients had isolated sternal fracture and 44 sustained in addition fractured ribs, flail chest, pneumo-haemothorax, pneumo-haemomediastinum, some of them experienced respiratory failure, vertebral fractures, myocardial infarction, heart contusion, pericarditis, head injuries, fractures of upper lower limbs and intraperitoneal bleeding. Twelve patients were admitted in ITU and 4 with multiple trauma were fatally injured. Aortic tears or ruptures didn't occur in any of our patients. Sternal fracture as an isolated injury has a better prognosis compared to those with associated injuries. CONCLUSIONS: The management of sternal fracture is usually conservative with a good outcome, provided early diagnosis and treatment of concomitant injuries is offered from a well-trained and experienced medical team.