William Butcher’s research while affiliated with Bournemouth University and other places

To determine the level of training of General Surgeons in the UK in the Advanced Trauma Life Support (ATLS) course and their involvement with hospital trauma teams. Postal questionnaire sent to General Surgical Consultants and Higher Surgical Trainees (HSTs). 58% of General Surgeons who responded had attended ATLS, but only 30% of those who had been Consultants for more than 10 years. Eighty-seven percent considered the course 'essential' or 'some value'. Sixty-one percent of hospitals represented had a trauma team. A Consultant General Surgeon was a member of the team in 50% and the General Surgical HST in 82%. ATLS has been widely accepted by General Surgical Trainees and recently appointed Consultants. The trauma team approach to resuscitation has yet to become fully established in the UK and there is limited input from Consultant General Surgeons.

Objective: To determine the level of training of General Surgeons in the UK in the Advanced Trauma Life Support® (ATLS®) course and their involvement with hospital trauma teams. Methods: Postal questionnaire sent to General Surgical Consultants and Higher Surgical Trainees (HSTs). Results: 58% of General Surgeons who responded had attended ATLS®, but only 30% of those who had been Consultants for more than 10 years. Eighty-seven percent considered the course ‘essential’ or ‘some value’. Sixty-one percent of hospitals represented had a trauma team. A Consultant General Surgeon was a member of the team in 50% and the General Surgical HST in 82%. Conclusion: ATLS® has been widely accepted by General Surgical Trainees and recently appointed Consultants. The trauma team approach to resuscitation has yet to become fully established in the UK and there is limited input from Consultant General Surgeons.

The report Better Carefor the Severely Injured [London: The Royal College of Surgeons of England and the British Orthopaedic Association; 2000] states that an experienced general surgeon trained in the techniques required to perform life-saving emergency surgery is vital in the management of major trauma. The experience and training of general surgeons in the UK in the management of trauma to the abdomen, thorax and major vessels has never been assessed. Postal questionnaire sent to UK general surgical consultants and Higher Surgical Trainees (HSTs). A total of 854 (48%) questionnaires were completed. Of respondents, 85% believe that major trauma should be directed to hospitals that provide a dedicated trauma service. Of non-vascular specialists, 43% felt their training was adequate to manage vascular trauma and only one-third of general surgical consultants felt adequately prepared to manage acute cardiothoracic injuries. The median number of trauma laparotomies undertaken annually was 2 for blunt injury and 1 for penetrating injury. Of HSTs, 21% had not performed a splenectomy for trauma and 44% had no experience of packing for liver injuries. There is limited experience and training in the surgical management of torso trauma in the UK. Implementation of the recommendations from Better Care for the Severely Injured will be hampered unless steps are taken to maximise experience and improve training.