Training in advanced trauma life support

Advanced trauma life support offers clear protocols for managing major trauma and is now regarded as a common international language of trauma care.1-3 In 1993 Teanby et al highlighted the generally poor care given to trauma victims in Britain and recommended that protocols for advanced trauma life support should be instituted in prehospital care as well as accident and emergency departments.4 Most, if not all, major British accident departments now use the protocols in their resuscitation rooms. Similarly, the number of advanced trauma life support courses have expanded since the first one in Britain in 1988 (Royal College of Surgeons, personal communication). But is this training being provided to those who need it most? Despite the maturation of accident and emergency medicine as a specialty and the formation of trauma teams in many hospitals, a senior house officer is often still the first doctor to assess and provide initial care for …