Prehospital Trauma Life Support
Framework - Historical background
Prehospital treatment of injured patients is addressed by health systems worldwide.
The education programme Prehospital Trauma Life Support (PHTLS) is an intensive seminar on the prehospital treatment of trauma. With a presence in 69 countries, it is the most renowned continuing education programme worldwide and numbers, at global level, approximately 11,000 certified instructors and 700,000 certified trained health care professionals.
PHTLS aims to educate all health care professionals who are active in prehospital treatment and who support severely suffering patients from the time of injury by means of treatment at the incident site, throughout management during the evacuation process, and until complete transfer to trauma teams of Emergency Departments (EDs).
The goal of PHTLS is to reduce the number of needless deaths and disabilities resulting from trauma. Implementing proper prehospital care can often make the difference between life and death or between a life with temporary, severe or permanent disability, on the one hand, and a productive and flourishing one, on the other.
PHTLS, the brainchild of the successful programme Advanced Trauma Life Support (ATLS), which provides mainly medical staff with training in the treatment of injured patients in health units, has been designed and implemented since 1983 by the National Association of Emergency Medical Technicians (ΝΑΕΜΤ), in cooperation with the American College of Surgeons (ACS).
The programme material, which is set out by a special scientific committee of NAEMT and ACS, combines all of the most recent scientific data. Its curriculum is correspondingly modified every four years to adapt to such data and a new manual that includes all of the updated content is issued. Moreover, worldwide implementation of the programme is monitored effectively.
In Greece, the professor of Surgery at the Medical School of the University of Patras I. Androulakis was the first one to recognize the utility of the education programme which, thanks to his actions, was launched in 1998 in Greece, and, with the assistance of collaborators, was disseminated throughout Greece and Cyprus. Notably, 211 high-quality education programmes involving 4,773 certified trained professionals and 128 certified active instructors have already been implemented in Greece.
PHTLS is carried out in accordance with Law 4655/2020 (Government Gazette, Series I, No 16/31-1-2020), with the exclusive financial support of Stavros Niarchos Foundation (SNF), over a five-year pilot phase. The cooperating bodies are the National and Kapodistrian University of Athens (UoA), Health Units SA (AEMY SA), the Ministry of Health, Prehospital Care as the responsible scientific body of NAEMT in Greece (National Coordinating Organization – NCO) and the civil non-profit organization Regeneration & Progress (R&P), which has been designated responsible for the financial management and technical supervision of these programmes. After the lapse of the five-year period, financial support continues to be provided through resources of the Ministry of Health.
In accordance with Law 4655/2020, the subsidized PHTLS seminar is targeted at rescuers in service – ambulance crews, nurses and doctors who serve at the National Emergency Aid Center (EKAV) as well as at Health Centers (PHC) all over Greece. Participation in the certified PHTLS training for health professionals is a benchmark from the point of view of thorough collection and recording of the necessary characteristics, to the benefit of severely suffering patients. At the same time, a common language is developed for communication and for treatment of severely suffering patients.
PHTLS incorporates both theoretical knowledge, which invariably relies on the most recent scientific data, and the buildup of technical skills for the purpose of systematic training that is provided in accordance with a specific protocol for treatment of severely suffering patients, which includes:
- Safe approach to the incident site
- Rapid and reliable primary health care assessment of injured patients as well as their urgent extrication, where required
- Identification of life-threatening conditions, such as hypoxaemia, shock, etc. and treatment thereof
- Knowledge regarding proper immobilization of injured patients
- Carrying out of full secondary health care assessment as well as rapid and safe transportation to the nearest and most suitable health unit
The values of PHTLS are encoded as Treat as You Go method, namely addressing life threats during evacuation of patients, which combines ideally the Scoop and Run and the Stay and Play approaches that have been implemented in the past.
The educational procedure, with duration of 16 hours, aims at continuously upgrading the health services offered to severely suffering patients and includes the following subjects:
- Physiology of life and death
- Kinematics of trauma
- Incident scene assessment and management
- Assessment and management of injured patients
- Airway, oxygenation and ventilation management
- Management of external and internal bleeding
- Management of special situations
- Immobilization and evacuation
For employees at the National Emergency Aid Center (EKAV) (rescuers – nurses – doctors):
Employment certificate, dated in the last six months, which is issued by the Personnel Department at the branch where employees serve, upon their request.
For beneficiaries in Primary Health Care (PHC) as employees at Health Centers (rescuers – nurses – doctors):
Employment certificate dated in the last six months, indicating the Primary Health Care structure where interested persons serve as well as their employment relationship. Alternatively, a solemn declaration dated in the last six months and issued by the director of the Primary Health Care structure, indicating the interested person’s employment relationship and specialty.
Below are the scheduled training programs . Please choose a seminar to go the relevant page for more information.