ATLS for Doctor

American College of Surgeons

dr. Afifah Alfyanita / dr. Elsa Prima Putri

ANATOMY

Scalp

Skull

Meninges

Brain

Cerebrospinal Fluid

Tentorium
SKULL
MENINGES
BRAIN
TENTORIUM
 PHYSIOLOGY

Intracranial
Pressure

Monro-
Cerebral
Kellie
Blood Flow
Doctrine
Monro-Kellie Doctrine
CLASSIFICATION

Mechanism of Injury

Severity of Injury

Morphology
 Blunt
Mechanism
Penetrating
Head Trauma
Mild

Severity Moderate

Severe

Vault
Skull Fracture
Basilar
Morphology
Focal
Intracranial
Lesions
Diffuse
CT scan of Intracranial Hematomas
 MANAGEMENT

Severe
Moderate
Mild
MILD BRAIN INJURY (GCS 14-15)

History of the Physical Workup

patient examinations

• Name, Age, • General • X-rays

Sex, examination • Blood Alcohol
Occupaton • Limited level and urine
• Mechanism of neurologic toxicology
injury examination screen
• Time of injury • CT-scan
• Loss of
consciousness
post injury
• Amnesia
• Headache
Observe In or Admit to Hospital

No CT scanner
Abnormal CT scan Penetrating trauma
available

Prolonged loss of Deterioration Alcohol

consciousness consciousness intoxication

Significant
Skull fracture CSF leak
associated injuries

No reliable Focal neurologic

Abnormal GCS
companion at home deficits
Discharge from Hospital

Discuss need to
Not Meet any of the return if any
criteria of problems develop
admission and issues a
Warning Sheet

Schedule follow up
visit
MODERATE BRAIN INJURY
(GCS SCORE 9–13)
SEVERE BRAIN INJURY
(GCS SCORE 3–8)