Rural Trauma Team Development Course© (RTTDC)

A Brief Overview

The Purpose of RTTDC

• To train rural hospital and clinic personnel in a team approach to the initial assessment and resuscitation of the injured patient

• To rapidly initiate transfer to definitive care when appropriate

RTTDC Objectives

• To improve care of the rural trauma patient by:– Establishing a trauma team using the

personnel and resources available at a facility– Developing a team approach to trauma

resuscitation, stabilization and prompt transfer– Identifying key factors in organizing and

preparing the resuscitation area and equipment

Who teaches RTTDCs?

• RTTDCs are taught by personnel from an area’s level I, II or III trauma center – Builds the working relationship between a

trauma center and its referring facilities– Allows personnel at the area trauma center to

see first-hand the resources available at the referring facility

Who is the RTTDC audience?

• Physicians

• Nurse Practitioners

• Physician Assistants

• Nurses

• Pre-hospital providers

• ED, radiology, respiratory and laboratory technologists

• Administrative personnel

Anyone who is available and able to play a role on a facility’s trauma team, including….

Rural Trauma Team Composition

• Teams have a core of at least three members– Suggested roles depend on available personnel

• Team leader (Physician, NP or PA)• Team member #1 (Nurse)• Team member #2 (Nurse, technician, prehospital provider,

other)

• Teams may have more than three members– Extended team members are personnel available to support the core team

Course Site Requirements

• Room large enough to seat audience for lectures• Additional room(s) for Team Performance

Scenarios– Ideally held in rural facility’s ED

• AV equipment (LCD, screen, speakers)– Microphone for instructors

• Laptop computer– Important to make a trial of the course slides on the

actual laptop that will be used at the course

Equipment requirements• Minimal equipment needed

– Intubation heads, adult and pediatric

– Endotracheal tubes and laryngoscopes

– Broselow® tape

– Chest tube and needle for chest decompression

• Scenarios can use manikins, or patient models if available

RTTDC Format

• 8 ½ hour course– Can be taught in modules also

• Interactive lectures and patient scenarios– Teams sit and work together throughout course

• Course worksheets – Completed by teams during course– Help to identify and note individual team member

responsibilities

RTTDC Format: Lectures

• ABCDE of trauma– Airway

– Breathing

– Circulation

– Disability

– Exposure and environment

• Transfer to definitive care• Pediatric trauma

RTTDC Format: Lectures• Special considerations in trauma

– Pregnancy

– Burns

– Geriatric

• PIPS (performance improvement and patient safety)

• Communications– General overview of subject in video lecture

– Role-playing scenarios on video

RTTDC Format: Scenarios• Team Performance Scenarios

– Teams rotate through three patient scenarios• With prior approval, may substitute real cases for

course scenarios

– Staged as closely to team’s ED as possible• Information on facility resources gathered pre-

course

– Helps identify areas to change• Critiquing by instructors• Self-critiquing by teams

RTTDC Policies

• ACS provides 8.25 CMEs for physicians– Non-physicians can claim credits from other

organizations• Can have up to 30 participants• Course can be held for teams from multiple

facilities• Courses must be approved by Chair of RTTDC

committee and ACS staff

RTTDC Costs

• RTTDC 3rd edition text– $50.00 each, plus shipping

• Other possible costs– Travel for course faculty– Venue rental– AV equipment rental– Lunch and breaks– Miscellaneous small expenses (phone,

copying, postage, etc.)

How To Request An RTTDC

• Rural facility identifies a facilitator to work with course coordinator– Facilitator makes on-site arrangements and

helps organize participants into teams• Facilitator contacts course coordinator at area

trauma center• Course coordinator sends pre-course

questionnaire to gather information about facility resources and needs

Does RTTDC Make a Difference?

An ongoing study in West Virginia has found that RTTDC significantly reduces delays in the transfer process of rural trauma patients.

Summary• Teaches rural trauma teams to quickly assess

patients for injuries requiring prompt transfer• Using faculty from the area trauma center builds

working relationships• Tailored to a facility’s resources and needs• Shown to improve time to decide to transfer• Designed to be simple and economical to present

For Further Information

The RTTDC program is administered by the American College of Surgeons Trauma Programs office. For more information or for other assistance with RTTDC, please call (312) 202-5380 or email to rttdc@facs.org.