Advanced Trauma Life Support
1. Basic Outline of ATLS Proto- 1. Preparation
col? 2. Triage
3. Primary survey (ABCDE)
4. Adjunct to Primary survey
5. Re-assess ABCDE and consider need for transfer
6. Transfer if needed
7. Secondary Survey (AMPLE + all physicals)
8. Adjuncts to second Survey
9. Pt. re-evaluation
10. Definitive Care.
2. What is included in the Pri- -Airway and C-Spine
mary survey of a trauma pa- -Breathing and Ventilation
tient? -Circulation/bleeding control
-Disability (Neuro Eval)
-Exposure and Environmental control.
3. What are adjuncts to Pri- ECG monitoring
mary Survey and Resuscita- Urinary/Gastric Catheters
tion? Other Monitoring (ABG, capnography)
X-ray and Dx studies.
4. What makes up the Sec- AMPLE Hx and Detailed Physical Exam
ondary Survey? Mechanism of Injury
Head and Maxillofacial
C-spine
Chest
Abdomen
Perineum/Rectum/Vagina
Musculoskeletal
Neurologic
, Advanced Trauma Life Support
5. What is something you Ask the pt. a question. If they can respond it can give you an idea
could do to get a quick as- about their airway and mental status. Failure to respond tells you
sessment of ABCD? there are abnormalities in ABCD.
6. What assumption can safely That the C-spine is compromised.
be made in a pt. with blunt
multisystem trauma above
the clavicle or Altered men-
tal status?
7. 4 Steps to manage A? Assess for patency
Establish airway
Maintain C-spine
Reinstate Proper C-spine devices.
8. 2 steps to Breathing? 1.Expose Neck and chest to inspect and palpate. Percuss chest for
presence of dullness or hyperresonance, auscultate chest bilater-
ally. All this checking for Tension Pneumo, Flail chest, Hemothorax,
Open Pneumothorax.
2. Administer High concentration O2, ventilate with bag, alleviate
Tension Pneumo, attach CO2 monitor to ET tube, Pulse ox.
9. What is the predomi- Hemorrhage.
nant cause of preventable
deaths after injury?
10. 2 steps to managing C? 1. Identify any sources of external/internal bleeding bleeding. The
four big areas for massive bleeding include: Chest, Abdomen,
Pelvis, Femur Fx.
Assess Pulse quality, color of skin level of consciousness, BP.
2. Large bore IVs and obtain blood samples. Type and cross,
, Advanced Trauma Life Support
ABG.
Warm Fluids/blood.
11. T or F: Aggressive and con- True.
tinued volume resuscitation
is not a substitute for defini-
tive control of hemorrhage.
12. best way to stop shock? 1) ID and stop the bleed -> enhances VR
2) volume repletion - but will only help if the source of the bleed is
identified
- restores CO, end organ perfusion, tissue oxygenation
13. Do u need a surgeon in a - yes!
trauma shock? - presence of shock in a trauma pt warrants immediate involvement
of a surgeon
- arrange early transfer if not equipped to handle injuries
14. Blood loss Classifications? Class 1: <15% -> no s/s -> blood donation -> monitor
Class 2: 15-30% -> low pp, tachy/tachypn, urine output mildly
attected -> crystalloids
Class 3: 30-40% -> " " and low urinary flow -> stop hemor-
rhhage/embolization -> crystalloids +/- BLOOD
Class 4: >2000mL Loss= >40% -> surgery & massive transfusion
Urine output will be less.
HR will increase.
BP decreases
Respiratory Rate Increases.
15. At what class Should you Class 3 or higher.
start Blood transfusing?
1. Basic Outline of ATLS Proto- 1. Preparation
col? 2. Triage
3. Primary survey (ABCDE)
4. Adjunct to Primary survey
5. Re-assess ABCDE and consider need for transfer
6. Transfer if needed
7. Secondary Survey (AMPLE + all physicals)
8. Adjuncts to second Survey
9. Pt. re-evaluation
10. Definitive Care.
2. What is included in the Pri- -Airway and C-Spine
mary survey of a trauma pa- -Breathing and Ventilation
tient? -Circulation/bleeding control
-Disability (Neuro Eval)
-Exposure and Environmental control.
3. What are adjuncts to Pri- ECG monitoring
mary Survey and Resuscita- Urinary/Gastric Catheters
tion? Other Monitoring (ABG, capnography)
X-ray and Dx studies.
4. What makes up the Sec- AMPLE Hx and Detailed Physical Exam
ondary Survey? Mechanism of Injury
Head and Maxillofacial
C-spine
Chest
Abdomen
Perineum/Rectum/Vagina
Musculoskeletal
Neurologic
, Advanced Trauma Life Support
5. What is something you Ask the pt. a question. If they can respond it can give you an idea
could do to get a quick as- about their airway and mental status. Failure to respond tells you
sessment of ABCD? there are abnormalities in ABCD.
6. What assumption can safely That the C-spine is compromised.
be made in a pt. with blunt
multisystem trauma above
the clavicle or Altered men-
tal status?
7. 4 Steps to manage A? Assess for patency
Establish airway
Maintain C-spine
Reinstate Proper C-spine devices.
8. 2 steps to Breathing? 1.Expose Neck and chest to inspect and palpate. Percuss chest for
presence of dullness or hyperresonance, auscultate chest bilater-
ally. All this checking for Tension Pneumo, Flail chest, Hemothorax,
Open Pneumothorax.
2. Administer High concentration O2, ventilate with bag, alleviate
Tension Pneumo, attach CO2 monitor to ET tube, Pulse ox.
9. What is the predomi- Hemorrhage.
nant cause of preventable
deaths after injury?
10. 2 steps to managing C? 1. Identify any sources of external/internal bleeding bleeding. The
four big areas for massive bleeding include: Chest, Abdomen,
Pelvis, Femur Fx.
Assess Pulse quality, color of skin level of consciousness, BP.
2. Large bore IVs and obtain blood samples. Type and cross,
, Advanced Trauma Life Support
ABG.
Warm Fluids/blood.
11. T or F: Aggressive and con- True.
tinued volume resuscitation
is not a substitute for defini-
tive control of hemorrhage.
12. best way to stop shock? 1) ID and stop the bleed -> enhances VR
2) volume repletion - but will only help if the source of the bleed is
identified
- restores CO, end organ perfusion, tissue oxygenation
13. Do u need a surgeon in a - yes!
trauma shock? - presence of shock in a trauma pt warrants immediate involvement
of a surgeon
- arrange early transfer if not equipped to handle injuries
14. Blood loss Classifications? Class 1: <15% -> no s/s -> blood donation -> monitor
Class 2: 15-30% -> low pp, tachy/tachypn, urine output mildly
attected -> crystalloids
Class 3: 30-40% -> " " and low urinary flow -> stop hemor-
rhhage/embolization -> crystalloids +/- BLOOD
Class 4: >2000mL Loss= >40% -> surgery & massive transfusion
Urine output will be less.
HR will increase.
BP decreases
Respiratory Rate Increases.
15. At what class Should you Class 3 or higher.
start Blood transfusing?
