ATLS Questions with answers

=> E in ATLS - *Airway* (and c-spine and catastrophic haemorrhage) *-* If answering questions that airway is patent *-* Use jaw thrust to protect c-spine *-* Give 100% oxygen *-* Assume c-spine injury in blunt trauma until proven otherwise (x-ray or satisfies Canadian c-spine rules) *Breathing* *-* Assess oxygenation with pulse oximetry *-* Check air entry with auscultation (also auscultate heart) *-* Inspect, palpate and percuss chest wall *-* Check RR and chest trauma *Circulation* (and haemorrhage control) *-* Assess central and peripheral pulses *-* BP *-* Place two large (at least 16 gauge) cannulae *-* Take bloods: *crossmatch*, FBC, U&E, clotting, VBG, ABG *-* Control any visible haemorrhage with pressure and consider possible sources of occult haemorrhage if no source identified but the patient is shocked *-* If low BP consider fluids (ATLS dictates 1L warmed Hartmann's/0.9% saline although growing evidence for hypotensive resuscitation) *-* If significant haemorrhage and persistent haemodynamic instability *transfuse: platelets, FFP and RBCs in ratio 1:1:1* (warm whole blood has better outcomes but often not available) *Disability* *-* Check *GCS/AVPU*, pupillary reflexes, gross evidence of a lateralizing injury or spinal cord level *-* Check BM