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Thies KC, Bergmans E, Billington A, Fraga GP, Trummer F, Nasr AO, Tilsed J, Kamaras G, Cebula G, Protic A, Khalifa GEA, Vänni V, Alouini S, Uštar KK, Perfetti P, Sari F, Cimpoesu D, Cassar MR, Lott C, Blondeel L, Kooij F, Neutel E, Verdonck P. The European Trauma Course: Transforming systems through training. Resusc Plus 2024; 18:100599. [PMID: 38515443 PMCID: PMC10955415 DOI: 10.1016/j.resplu.2024.100599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024] Open
Abstract
The European Trauma Course (ETC) exemplifies an innovative approach to multispecialty trauma education. This initiative was started as a collaborative effort among the European Society for Emergency Medicine, the European Society for Trauma and Emergency Surgery, and the European Society of Anaesthesiology under the auspices of the European Resuscitation Council. With the robust support of these societies, the project has evolved into the independent European Trauma Course Organisation. Over the past 15 years, the ETC has transcended traditional training by integrating team dynamics and non-technical skills into a scenario-based simulation course, helping to shape trauma care practice and education. A distinctive feature of the ETC is its training of doctors and allied healthcare professionals, fostering a collaborative and holistic approach to trauma care. The ETC stands out for its unique team-teaching approach, which has gained widespread recognition as the standard for in-hospital trauma care training not only in Europe but also beyond. Since its inception ETC has expanded geographically from Finland to Sudan and from Brazil to the Emirates, training nearly 20,000 healthcare professionals and shaping trauma care practice and education across 25 countries. Experiencing exponential growth, the ETC continues to evolve, reflecting its unmet demand in trauma team education. This review examines the evolution of the ETC, its innovative team-teaching methodology, national implementation strategies, current status, and future challenges. It highlights its impact on trauma care, team training, and the effect on other life support courses in various countries.
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Affiliation(s)
- Karl-Christian Thies
- EvKB, Dept of Anaesthesia and Critical Care, Bielefeld University Medical Center-Campus Bethel, Bielefeld, Germany
- European Trauma Course Organisation, Niel, Belgium
| | - Elonka Bergmans
- EvKB, Dept of Anaesthesia and Critical Care, Bielefeld University Medical Center-Campus Bethel, Bielefeld, Germany
| | | | - Gustavo P. Fraga
- Dept of Trauma Surgery, Vera Cruz Hospital-Trauma Center, Faculty of Medicine, University of Campinas, Campinas, Brazil
| | | | - Ayman O. Nasr
- Trauma Unit, King Fahad University Hospital & College of Medicine, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
| | - Jonathan Tilsed
- European Trauma Course Organisation, Niel, Belgium
- Hull York Medical School, United Kingdom
- UEMS Division of Emergency Surgery, European Society for Trauma and Emergency Surgery, United Kingdom
| | - Georgie Kamaras
- Luton and Dunstable University Hospital, Luton, United Kingdom
| | - Gregorz Cebula
- Jagiellonian University Medical College, Center for Innovative Medical Education, Kraków, Poland
| | - Alen Protic
- Department of Anesthesiology, Intensive Medicine and Pain Therapy, University Hospital Rijeka, Rijeka, Croatia
| | - Gamal Eldin Abbas Khalifa
- European Trauma Course Organisation, Niel, Belgium
- Emergency and Disaster Medicine, Egyptian Resuscitation Council, Egypt
| | | | | | - Katja Kalan Uštar
- Dept of Anaesthesia and Critical Care, Trbovlje General Hospital, Trbovlje, Slovenia
| | - Paola Perfetti
- Emergency Department at Latisana, Azienda Sanitaria Universitaria Friuli Centrale, Italy
| | - Ferenc Sari
- European Trauma Course Organisation, Niel, Belgium
- Department of Emergency Medicine, Skellefteå Hospital, Region Västerbotten, Sweden
| | - Diana Cimpoesu
- University of Medicine and Pharmacy “Grigore T. Popa”, Emergency Medicine, II-nd Surgery Department, Hospital “Sf. Spiridon” Iasi, Romania
| | - Mary Rose Cassar
- Emergency Department, Mater Dei Hospital, Malta, University of Malta, Malta
| | - Carsten Lott
- European Trauma Course Organisation, Niel, Belgium
- Klinik für Anästhesiologie, Universitätsmedizin Mainz, Mainz, Germany
| | | | - Fabian Kooij
- European Trauma Course Organisation, Niel, Belgium
- Anesthesiologie Amsterdam UMC, locatie AMC, Amsterdam Zuidoost, Netherlands
| | - Elizabete Neutel
- European Trauma Course Organisation, Niel, Belgium
- Department of Anaesthesiology, Intensive Care Medicine and Emergency. Unidade Local de Saúde de Santo António, Porto, Portugal
| | - Philip Verdonck
- Emergency Departement, Antwerp University Hospital, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium
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Nasr AO, Lulic I, Mustafa MT, Tilsed J, Lulic D, Thies K. Bringing critical emergency medicine, resuscitation and trauma education and training back to armed rivalry-affected community: why the conflict in Sudan matters? Eur J Trauma Emerg Surg 2023; 49:2633-2635. [PMID: 37311993 DOI: 10.1007/s00068-023-02302-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 06/02/2023] [Indexed: 06/15/2023]
Affiliation(s)
- Ayman O Nasr
- Trauma Unit, Department of Surgery, King Fahad Hospital of the University, Al Aqrabiyah, Al Khobar, 34445, Kingdom of Saudi Arabia.
- Human Resuscitation Organization, AlRiyadh District, Khartoum, Sudan.
| | - Ileana Lulic
- Department of Anesthesiology, Intensive Care and Pain Medicine, Clinical Hospital Merkur, Zajceva 19, 10 000, Zagreb, Croatia
| | - Mahmoud T Mustafa
- Human Resuscitation Organization, AlRiyadh District, Khartoum, Sudan
| | - Jonathan Tilsed
- Department of Surgery, Hull University Teaching Hospitals NHS Trust, Anlaby Rd, Hull, HU3 2JZ, UK
| | - Dinka Lulic
- Department of Emergency Medicine, Saint James Hospital, George Borg Olivier St, Sliema, SLM 1807, Malta
| | - Karl Thies
- Department of Anesthesiology, Intensive Care, Emergency Medicine, Transfusion Medicine and Pain Therapy, EvKB University Hospital of Bielefeld, Campus Bethel, Burgsteig 13, Bielefeld, Germany
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Nasr AO, Al-Harbi TM, AlRamadan FS. Case report; successful treatment of traumatic ischaemic hemiplegia secondary to blunt carotid injury associating high grade liver trauma. Int J Surg Case Rep 2021; 88:106547. [PMID: 34753099 PMCID: PMC8581270 DOI: 10.1016/j.ijscr.2021.106547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/22/2021] [Accepted: 10/27/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION AND IMPORTANCE Blunt carotid injury (BCI) injury is a rare sequel of trauma and could result in ischemic complication if not detected and treated early. The presence of high-grade solid organ injury with ongoing bleeding represents additional challenge in treating BCI. CASE PRESENTATION A 25-year-old victim of motor vehicle collision resulted in grade IV liver, grade III left kidney and grade I spleen injury. He underwent an urgent laparotomy with transient liver packing at local hospital. A full body Contrast-Enhanced Computer Tomography (CECT) upon arrival revealed right internal carotid intimal tear with intra and extra-cranial thrombosis and a 3 cm aneurysm. With a decreased level of consciousness, the patient showed a GCS of 13 and left-sided hemiplegia. After complex multidisciplinary treatment sessions, patient recovered with a partial regain of left-sided muscle power. CLINICAL DISCUSSION Selective embolization of active liver bleeding was a turning point in the management of our patient as it deferred the need for a second operative intervention. It was a necessary step before endovascular stenting and recanalization of the BCI to restore the circulation to the right cerebral hemisphere. Dual anti-platelet therapy (DAPT) was necessary to prevent thrombosis of the stent and continuity of carotid recanalization. CONCLUSION BCI with traumatic ischaemic hemiplegia associating a sum of life-threatening multiple injuries including high grade liver trauma with ongoing bleeding could still be managed non-operatively with acceptable outcome in the presence of a comprehensive specialized multidisciplinary service.
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Affiliation(s)
- Ayman O Nasr
- Department of Surgery, King Fahad Hospital Of University-Collage of Medicine, Imam Abdulrahman Bin Faisal University, Saudi Arabia.
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Nabri M, Alromaih NJ, Othman SA, Alghusnah ES, Abu Al Ola H, Elbagir A, Nasr AO. Blunt Abdominal Trauma Leading to an Incidental Finding of Duplicate Inferior Vena Cava (DIVC): A Case Report and Literature Review. Am J Case Rep 2021; 22:e929198. [PMID: 34061818 PMCID: PMC8183301 DOI: 10.12659/ajcr.929198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND With a prevalence of about 2% to 3%, duplication is the most common anomaly associated with the inferior vena cava (IVC). In general, systemic venous anomalies are being more frequently diagnosed in asymptomatic patients. We report the case of a young man with an incidental finding of an asymptomatic duplicated IVC, along with a literature review. CASE REPORT A 36-year-old man was brought to our Emergency Department (ED) following a high-speed motor vehicle collision (MVC), reporting right flank and hip pain. Upon examination, the "seatbelt sign" was noticed, along with abrasions over his right side. He sustained a small-bowel mesenteric injury, for which he was admitted and was treated conservatively. A CT scan incidentally revealed a duplicate IVC (DIVC). He later underwent a laparotomy with limited right hemi-colectomy and was discharged home in good condition. CONCLUSIONS Undiscovered and asymptomatic DIVCs pose a potential risk to patients during clinical interventions. Advancements in diagnostic imaging contribute greatly to the incidental discoveries of inferior vena cava duplication.
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Affiliation(s)
- Mamoun Nabri
- Department of General Surgery, King Fahad Hospital of University, College of Medicine, and Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Norah J Alromaih
- Department of General Surgery, King Fahad Hospital of University, College of Medicine, and Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Sharifah A Othman
- Department of General Surgery, King Fahad Hospital of University, College of Medicine, and Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Elham S Alghusnah
- Department of General Surgery, King Fahad Hospital of University, College of Medicine, and Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Hossain Abu Al Ola
- Department of Radiology, King Fahad Hospital of University, College of Medicine, and Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Adel Elbagir
- Department of General Surgery, King Fahad Hospital of University, College of Medicine, and Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Ayman O Nasr
- Department of General Surgery, King Fahad Hospital of University, College of Medicine, and Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
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Nasr AO, ElKhazin S, Mustafa MT. Monitoring ERC course quality & faculty performance using Pareto's principle. Resuscitation 2019. [DOI: 10.1016/j.resuscitation.2019.06.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Nasr AO, Dillon MF, Conlon S, Downey P, Chen G, Ireland A, Leen E, Bouchier-Hayes D, Walsh TN. Acid suppression increases rates of Barrett’s esophagus and esophageal injury in the presence of duodenal reflux. Surgery 2012; 151:382-90. [DOI: 10.1016/j.surg.2011.08.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Accepted: 08/18/2011] [Indexed: 12/14/2022]
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Darwish A, Nasr AO, El Hassan LA, Fahal AH. Cyclosporine-A therapy-induced multiple bilateral breast and accessory axillary breast fibroadenomas: a case report. J Med Case Rep 2010; 4:267. [PMID: 20701786 PMCID: PMC2928248 DOI: 10.1186/1752-1947-4-267] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2009] [Accepted: 08/11/2010] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Breast adenoma is common. However, in the setting of post-transplantation immune suppression it may be expressed differently. CASE PRESENTATION A 35-year-old Sudanese woman, with a history of renal transplantation two and half years prior to presentation, was on a single immune suppression therapy in the form of cyclosporine-A since the transplantation. During a regular follow-up visit, she was noticed to have gingival hypertrophy and bilateral breast and axillary swellings. She underwent successful surgical resection of the bilateral fibroadenomas. CONCLUSIONS Cyclosporine-A therapy post renal transplantation is associated with an increased incidence of benign breast changes as fibroadenoma. Regular follow-up and appropriate selection of immunosuppressant therapy are essential in the post transplantation management of these patients.
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Affiliation(s)
- Ahmed Darwish
- P,O, Box 102, Department of Surgery, Faculty of Medicine, University of Khartoum, Sudan.
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Abdelgadir MA, Mahadi SEI, Nasr AO, Ahmed ME. Role of jejunostomy feeding catheter as a model for nutritional support. Int J Surg 2010; 8:439-43. [DOI: 10.1016/j.ijsu.2010.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Revised: 04/19/2010] [Accepted: 05/18/2010] [Indexed: 01/10/2023]
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Abstract
OBJECTIVE The purpose of this study was to discuss the treatment of a case of spontaneous intestinal herniation per vagina in a patient who had undergone previous transabdominal hysterectomy and to review the related literature. STUDY DESIGN A computer-based search of the English literature from January 1900 to October 2004 with the use of the terms vaginal herniation, vaginal evisceration, and vaginal trauma/injury was performed. Causes, presentation, and treatment were discussed and compared with a recent case that was treated locally in our hospital. RESULTS Vaginal evisceration was described in the literature as early as 1864; since then <100 cases have been reported in the literature. It is more common in menopausal women with previous hysterectomy pelvic or vaginal surgery. Vaginal trauma, as in rough coitus, instrumentation, obstetric injury, is a recognized cause in premenopausal women. CONCLUSION Vaginal evisceration is a rare, distressing emergency that requires aggressive resuscitation and urgent surgical intervention.
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Affiliation(s)
- Ayman O Nasr
- Department of Surgery, James Connolly Memorial Hospital, Blanchardstown, Dublin, Republic of Ireland.
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Abstract
Lipoma of the cord, once considered rare and insignificant, has been cast in a new light by laparoscopic pre-peritoneal surgery, with diagnostic and therapeutic implications. This study aimed to determine the incidence, significance and association of spermatic cord lipomas to inguinal hernias. A retrospective review was performed for all hernia operations carried out between January 1999 and November 2002. The incidence of cord lipomas and their relation to inguinal hernias were evaluated. There were 123 repairs performed on 111 patients, 90 of which were laparoscopic via the pre-peritoneal approach, 29 were open and 4 converted from laparoscopic to open in the early part of the series. All but two cases were male (neither female had associated lipoma of the round ligament). Twenty-six lipomas of the cord were identified with an incidence of 21%. Sixteen were associated with hernia and only 10 were pure cord lipoma, an incidence of 8%. Thirteen repairs represented recurrent hernias, two of which had pure cord lipoma, one had an associated sac. Only two lipomas were suspected clinically prior to surgery. Lipoma of the cord is a poorly recognised entity that can be present with groin symptoms and clinical findings indistinguishable from inguinal hernia. Its incidence was poorly appreciated prior to the laparoscopic era.
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Affiliation(s)
- Ayman O Nasr
- Department of Surgery, Connolly Hospital, Blanchardstown, Dublin 15, Ireland.
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