The Nebraska Incident and Inception
A tragedy occurred in February 1976 that changed trauma care in the ‘first hour’ for the injured patient. An orthopedic surgeon, Dr. Jim Styner, piloting his plane, crashed in a rural Nebraska cornfield. The surgeon sustained serious injuries, three of his children sustained critical injuries, and one child sustained minor injuries. His wife was killed instantly. He managed to take care of his family while waiting for rescue. The care he and his family received later at the hospital was inadequate. Recognizing how inadequate his treatment was, the surgeon stated: ‘When I can provide better care in the field with limited resources than what my children and I received at the primary care facility, there is something wrong with the system and it has to be changed.’
A group of private-practice surgeons and physicians in Nebraska in association with various other organizations identified the need for training in advanced trauma life support. A combined educational format of lectures, associated with life-saving skill demonstrations, and practical laboratory experience led in 1978 to the first prototype ATLS Course for doctors. This course was based on the assumption that appropriate and timely care could significantly improve the outcome of the injured. The original purpose of the ATLS Program was – and still is – to train doctors who do not manage major trauma on a daily basis. A year later, the American College of Surgeons (ACS) Committee on Trauma (COT), recognizing trauma as a surgical disease, enthusiastically adopted the course under the auspices of the College and incorporated it as an educational program.
Course Development and Dissemination
The ATLS Course was given nationally in the United States for the first time in 1980. Canada became an active participant in the ATLS Program in 1981. Countries in Latin and South America began implementing the program in 1986. Since its inception, the program has grown in terms of the number of courses, participants, and number of countries. By 2002, the course had trained some 400000 doctors in more than 63 countries. Currently some 1400 courses are held worldwide each year and the ATLS manual is now in its tenth edition (2018).
ATLS in Switzerland
During fall 1997, eight Swiss surgeons and anesthetists successfully participated in an initial ATLS training course in Columbia, South Carolina, comprising a student course followed by an instructor course. In June 1998 they organized and implemented the Inaugural Student and Instructor Courses in Basel under the supervision of the ACS National ATLS Faculty (doctors, educator, and coordinator). From then on, the ATLS training program could be offered by the ATLS Switzerland Faculty, and Switzerland became the 30th country to join the international ATLS community.
ATLS in Europe
ATLS Switzerland founded the ATLS Europe association with 13 other European countries. Today almost 20 European countries meet regularly to promote and develop ATLS taking intoaccount local protocols and trauma systems in our region.
