What is it?
Rural trauma is the "neglected disease" of the twenty-first century.
Why was the RTTDC developed?
The Rural Trauma Team Development Course (RTTDC), has been developed by the ad hoc Rural Trauma committee of the American College of Surgeons (ACS) Committee on Trauma (COT) to help rural hospitals with development of their trauma teams. It is hoped the course will improve the quality of care in their community by developing a timely, organized, and rational response to the care of the trauma patient and a team approach that addresses the common problems in the initial assessment and stabilization of the injured. It is the purpose of RTTDC to increase the efficiency of resource utilization and improve the level of care provided to the injured patient in the rural environment.
The course objectives are as follows:
- Describe components of their state, regional, and local trauma system as it currently exists.
- Identify components of an effective trauma system.
- Describe what is necessary to develop a rural trauma team.
- Describe what is necessary to prepare for their local hospital's treatment of the critically injured trauma patient.
- Outline the components of the Primary Survey, Decision for Transfer to Definitive Care, and Secondary Survey.
- Demonstrate the concepts of the Primary Survey, Decision for Transfer to Definitive Care, and Secondary Survey as applied in simulated injured patient scenarios.
Who should attend the course?
The basic premise of the course is the assumption that, in most situations, rural hospitals can provide three individuals to form the core of a trauma team consisting of a Team Leader (a physician or physician extender), Team Member One (a nurse), and Team Member Two (an additional individual who could be a nurse, aide, technician, pre-hospital provider, or clerk). Therefore, the rural hospital should have those individuals who will perform in these roles attend the course along with other individuals such as respiratory, radiology, and laboratory technologists, additional nurses, pre-hospital personnel, etc. who might be involved in supportive roles to the trauma team. The number of trauma teams will determine the number of instructors needed for the course. Based on the scenario teaching stations the course is best taught with a ratio of one instructor for each hospital team. Other hospital personnel involved in supportive roles may also participate. The number of teams is limited to seven (21 individuals) and total course participants to 30 individuals.
How is the course presented?
The course is designed to be given either in one day of approximately eight hours or can be given in four separate modules of 1.5-2 hours each or in a combination of modules. The rural hospital, in conjunction with the Course Director and Coordinator, will decide how the course is to be presented. This will depend on the availability of instructors, how long the participants can be away from their jobs, and travel distances involved.
Where can the course be presented?
The course can be presented in any facility with a large enough room to hold 20�30 participants for the didactic portion of the course. Good lighting, good acoustics, and the ability to accommodate a large projection screen and equipment for PowerPoint® presentation are other requirements. Additional space in this room, or additional rooms, is required to set up the team performance teaching stations. These stations must be far enough apart to allow reasonable conversational speech levels between the instructors and participants without interference from the other stations.
Who will present the course?
RTTDC is taught by surgeons, emergency physicians, family physicians, nurses, and/or paramedics who are experienced trauma care providers and trauma course instructors.
Who is responsible for the courses in your state?
The ACS COT Chairperson for your state, or his/her designee is charged with authorizing all RTTDC courses. In most states the responsibility of presenting the courses will be given to the Level I and II trauma centers in the vicinity of the rural hospital requesting the course. Most often this will be the trauma center to which the rural hospital refers its critically injured patients. These trauma centers have the responsibility to provide outreach education to their referring hospitals. Ultimate responsibility for RTTDC development, content, and overall quality management is the ad hoc Rural Trauma committee of the ACS COT.
Who should be contacted to arrange a course for a rural hospital?
There are a number of persons to contact including your state/provincial COT Chairperson, the trauma coordinator or trauma medical director at the trauma center to which you refer, and ad hoc Rural Trauma committee members involved in development of the course.
Who has information on the course?
In addition to your state chair, the Trauma Medical Director or Trauma Program Manager at your nearest referral trauma center may already be involved in the courses and be a source of information. Alternately the Trauma Programs Office at the ACS in Chicago can be contacted by phone at 312-202-5380 or by e-mail at email@example.com.
What obligations does the rural hospital have?
A questionnaire will be sent to the rural hospital prior to scheduling. The faculty will use the answers to determine what sections of the course might be stressed during the course proper and what should be presented during the elective portion of the course. In addition a list of suggestions for venue and equipment will be submitted. After the course there is brief evaluation paperwork that will be completed by the course director and coordinator. It is extremely important that the post-course evaluation by the students is collected, as this information will be pooled with that from other courses across the country allowing for effective updates and revisions.