ATLS

(Advanced Trauma Life Support)

Moderator : Dr. Deepak S
Ganesh Kumar
VIII Term

Introduction
Important

role in management of acute

trauma cases
Simplified and standardized approach to
trauma patients
Treat the greater threat first
Advocates importance of initial emergency
assessment of the patient over a detailed
history and a definitive diagnosis

ATLS vs. BTLS

Scope

to identify and manage more serious

conditions
Conducted by a well-organized Trauma Team

Components
Preparation
Triage
Primary

Survey
Resuscitation
Secondary Survey
Definitive Care

Primary Survey
Follows

on the lines of BTLS

Look for immediate threats to life
5 Components( ABCDE )

Primary Survey
A
B
C
D
E

Airway and cervical spine protection

Breathing
Circulation
Disability Evaluation
Environmental Control

A = Airway and Cervical Spine

Can

the patient talk??

Unconscious?? Chin lift, Jaw thrust
Airway adjuncts : Cricothyrotomy
Tracheostomy,
Endotracheal intubation
Aspirated vomitus or blood?? Suction
Cervical Spine Injury : Cervical Collar

Breathing and Ventilation

Examine

the chest
Look for : Subcutaneous emphysema
Chest wall injuries
Tension pneumothorax
Flail chest
Hemothorax

Circulation
Hemorrhage
External

bleed : Direct pressure

Occult bleed : Investigate
Hypovolemic Shock

Disability Evaluation
Basic

neurological assessment
Glasgow Coma Scale
Pupillary Response

GLASGOW COMA SCALE

Environmental Control
Undress

: look for other sites for signs of

trauma
Hypothermia?? : Warm IV fluids,
Warm environment

Resuscitation
IV

lines ( 2 large bore)

Control bleeding
Fluids
Blood
Screening X Rays :
3 C Spine, Chest , Abdomen
5- 3 + T Spine , L Spine

Secondary Survey
Begun

after primary survey is completed,

resuscitation efforts are well established, and
the vital signs are normalizing.

Secondary Survey( contd. )

Thorough

History
Head-to-toe Examination
Reassess vitals
Each region of the body must be fully
examined
X-rays indicated by examination are obtained
Go back to primary when condition
deteriorates

Definitive Care
Investigate

and diagnose associated

illnesses and treat accordingly

Trauma Team
A group

of health personnel who have no

other commitment that day than to receive
and treat trauma patients.
All staff should be trained in ATLS
techniques.

Trauma Team( Contd.)

Consists ideally of :
Team Leader
Anesthetist
Anesthetic Assistant
Emergency Physician
Two Nurses(Three if no anesthetic assistant)
Radiographer

 Other

specialties can be consulted

depending on the nature of the injury, for
example a neurosurgeon will attend if there is
a serious head injury.

Advantage

: Horizontal Organization
Higher efficacy
Disadvantage : Expensive setup

THANK YOU