“Trauma is my thing,” says Giselle Melanson, a retired nurse who worked in the Surgical Intensive Care Unit at the Montreal General Hospital (MGH) for over thirty years. She is at the Steinberg Centre for Simulation and Interactive Learning (SCSIL) to coordinate the Advanced Trauma Life Support (ATLS) workshop and make sure that everything runs smoothly.
ATLS was established by the American College of Surgeons to provide a concise approach to the assessment and management of priorities in multiple injured patients. This training is offered, for the most part, all over the world. In Montreal, ATLS workshops are organized in conjunction with the MGH Trauma Centre at the McGill University Health Centre and taught by experienced instructors from different divisions—medicine, anesthesia and so on.
“When I first got involved in this program with Dr. Rea Brown, we ran the workshops three or four times a year in the hospital setting, but it was getting difficult; we had to find space, move equipment, wait for elevators, and so on. Being at the SCSIL has opened up opportunities,” she explains. “We now offer a course every month, which is unusual, and there is a waiting list. Physicians and residents attend from across the country, and we have a couple of international participants at every workshop.”
"A lot of the participants are physicians in small communities; not everyone works in a big city and there’s trauma everywhere, as we know,” says Giselle. “This workshop gets them up to speed so that they are able to stabilize a patient and get them to a trauma centre.” At the end of the workshop, participants have to pass a written exam and master a simulation scenario component involving trauma patients to become certified.
Coordinating this workshop allows Giselle to stay connected, to meet lots of people from all over and to share stories. “It’s a very interesting division, trauma. It’s a whole different world. We’ve come a long way! I can tell you that as someone who started out 30 years ago,” she says. “It was a great job, I loved it. I’m retired, but I keep my hand in it by doing this.”
How did she manage her emotions while working in such a high-stress trauma environment? “I learned that from being a nurse. You have to be compassionate,” explains Giselle. “That doesn’t mean that you can’t get upset or you can’t be teary at work, we have all been there. We are not these very hardened people; actually most of us have a pretty soft heart. We’ve seen a lot and done a lot, and you don’t always win. That’s life in general, that’s the tough part. But I have a million stories of things that I didn’t think would work out but in the end, they did.”
Preparing for rare trauma cases
As a first-year pediatrics resident at CHU Sainte-Justine, Dr. Lionel Alberti wants to be ready for any possible emergency situations that may arise. He recently completed a rotation in Emergency Medicine but wanted more exposure to trauma, so he signed up for the ATLS workshop.
“This course gave me a very structured and simple framework that I can easily apply to any trauma setting,” explains Dr. Alberti. “The staff that’s presenting—the surgeons and anesthesiologists—are very experienced and provide lots of insights into what might happen during rare cases and interesting situations. Of course, it’s important to know what to do in the usual 99% of emergency cases, like broken arms for example, but here, in this workshop, you get the stories about that 1% that you may only see once in your lifetime.”
Dr. Alberti was impressed with the emphasis on the simulated skills stations and believes that the hands-on training will enhance his ability to remember what to do when faced with a rare trauma case: “Reading a textbook or hearing a lecture, you might have a list of 10 things you should do. But when you’re in the situation, with stress and everything, your body has a memory that your mind doesn’t—if you’ve done it before, if you’ve managed a similar situation in the past, you’ll do it automatically.”
