Advanced Trauma Life Support

Posted by e-Medical PPT
Advanced Trauma Life Support (ATLS) is a training program for doctors and paramedics in the management of acute trauma cases, developed by the American College of Surgeons.Originally designed for emergency situations where only one doctor and one nurse are present, ATLS is now widely accepted as the standard of care for initial assessment and treatment in trauma centers.
A - Airway Maintenance with Cervical Spine Protection
The first stage of the primary survey is to assess the airway. If the patient is able to talk, the airway is likely to be clear. If the patient is unconscious, he/she may not be able to maintain his/her own airway. The airway can be opened using a chin lift or jaw thrust.
B - Breathing and Ventilation
The chest must be examined by inspection, palpation, percussion and auscultation. Subcutaneous emphysema and tracheal deviation must be identified if present.The aim is to identify and manage six life threatening thoracic conditions as Airway Obstruction, Tension Pneumothorax, Massive Haemothorax, Open Pneumothorax, Flail chest segment with Pulmonary Contusion and Cardiac Temponade.
C - Circulation with Hemorrhage Control
Hemorrhage is the predominant cause of preventable post-injury deaths.Hypovolemic shock is caused by significant blood loss. Two large-bore intravenous lines are established and crystalloid solution given. If the patient does not respond to this, type-specific blood, or O-negative if this is not available, should be given.
D - Disability (Neurologic Evaluation)
During the primary survey a basic neurological assessment is made, known by the mnenomic AVPU.
E - Exposure / Environmental control
The patient should be completely undressed, usually by cutting off the garments. It is imperative to cover the patient with warm blankets to prevent hypothermia in the emergency department. Intravenous fluids should be warmed and a warm environment maintained. Patient privacy should be maintained.

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