iPhoneIcon_BigThe British ATACC concept – Anaesthesia Trauma And Critical Care – is as the name implies a course focusing on the anaesthestic (non-surgical) part of trauma and critical care treatment. The course was developed as a more advanced and up-to-date answer to the basic and slow-changing ATLS. The full ATACC manual is available free online . true #FOAM!

The online manual
The ATACC manual comes in three big volumes:

1. Introduction to trauma care and the prehospital management
2. Initial management and hospital trauma care
3. More specialised trauma considerations

For hospital docs, volume 2 and parts of volume 3 will be the most important ones, but the three volumes are sprinkled with pearls. I also love this part from the introduction in vol 1, outlining ATACC vs ATSL:

“…To be fair ATLS aimed to do nothing more than provide a robust background of trauma skills for clinicians who may face major trauma on an infrequent basis and have to manage it in a systematic fashion as part of a trauma team. It was never designed to be the course for leading major trauma centres and as such ‘advanced’ may not be the best title, but as an initial introduction it was a good start. Sadly, as our approach to trauma has progressed, a number of methods and principles of ATLS have proved incorrect, but these were slow to be changed, resulting in many disillusioned candidates and Faculty members. As such ATACC offered a fresh alternative.”

A more advanced trauma manual
And ATACC seems to have accomplished what they set out to do. They mention and discuss things like the abdominal tourniquet (they’re not convinced), different types of hemostatic dressings, musings on RSI (incl. apneic oxygenation), discussing sux vs roc, and outlining damage control resuscitation. Much of the curriculum is presented for the reader to judge instead of trying to present absolute truths. And all the chapters contains lots of good article references. And the manual will be continuously updated, so if you download, please check back from time to time to get the most updated version.

We commend the ATACC faculty for putting the full manual out there for all to access, read and discuss! It’s a great addition to our trauma management library!

The ATACC – Anaesthesia Trauma And Critical Care – manual

Also, if you’re on Twitter, follow the ATACC Faculty and Mark Forrest, Medical Director of ATACC. If you’re not on Twitter – get on.

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6 Responses to ATACC!

  1. Ibrahim Kushisha says:

    Great, i love it
    Please, more information, when, where, and how to attend this course, I’m anesthetist, intensivist, in Saudi Arabia, any chance, anywhere? Or online


  2. Jakob Mathiszig-Lee says:

    They’re not planning on exporting it. On the website it says that just running it in the UK takes so much effort from the faculty they don’t want to compromise standards by trying to run it elsewhere.

    As a junior doctor in the UK i’ll have to sit a trauma course soon and am so glad ATACC is now properly recognised by the Royal College of surgeons as an alternative to ATLS which i’m really not keen on.

  3. I direct on EMST-ATLS in Australia

    I’d love to bring ATACC ‘down under’ as many of the nuances of modern trauma management is not discussed in EMST-ATLS, even on our refresher courses.

    The ETMcourse out of Melbourne probably offers more FOAMed content – as do those run by RFDS like their STAR course (reviews on these over at &

    But ATACC seems to offer fully immersive sim and a variety of scenarios, with awesome instructors

    Putting their manual out as FOAMed was very, very generous – kudos to the team!

  4. Tom says:

    Having attended EMST/ATLS here in Australia, I heartily agree with the criticisms levelled at it in the ATACC manual. Whilst having an understanding of trauma management would be useful for the rural generalist, expecting a junior surgical registrar in a tertiary hospital to intubate patients (even in a simulation) is somewhat ridiculous. Looking forward to perusing the manual some more and possibly attending the course!

  5. …I am loathe to defend ATLS….but Tom, the point is that the junior surg reg needs to be aware of the decision-making when he/she is Team Leader, so can confidently state :

    “Right team, we are at A. Could the airway doctor secure the airway whilst assessment doctor assesses B and C?”

    The surgeon needs to be aware of the decision-making and order. Not how to intubate.

    What IS ridiculous about ATLS is that it teaches intubation with midazolam and sux…and that intubated patients in scenarios appear unsedated nor paralysed.

    ATAAC addresses airway nuances (as does ETM)….does this mean irrelevant for surgeons?

    You need to know what other team members are up to. And in scenarios on ATLS we will examine the junior surg reg on decision-making for control of A. We do not expect you to be able to intubate.

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