Advanced Trauma Life Support (ATLS) is one of the most widely used trauma life support training programmes globally, but there is currently no strong controlled-trial evidence that it improves patient outcomes. The ADVANCE TRAUMA trial is designed to compare ATLS training with standard care for trauma patients in India.
Batched stepped-wedge cluster randomised controlled trial.
Secondary and tertiary hospitals distributed across India. The full trial is planned across 30 hospital clusters organised into six batches.
Trauma patients aged 15 years or older who present to the emergency department of a participating hospital and are admitted, transferred for admission, or die before admission.
In-hospital mortality within 30 days of arrival at the emergency department.
Secondary outcomes include adherence to ATLS principles during initial resuscitation, quality of life, disability, hospital length of stay, intensive care unit length of stay, discharge destination, and complications.
The primary analysis will compare outcomes before and after ATLS training while accounting for clustering by hospital and time period in the stepped-wedge design.