, COMMITTEE ON TRAUMA
COURSE MANUAL | 11th Edition
Advanced Trauma
Life Support®
(ATLS )®
Standardized Trauma Care
When Seconds Count
,Chair, Committee on Trauma: Jeffrey D. Kerby, MD, PhD, FACS
Medical Director, Committee on Trauma: Eileen M. Bulger, MD, FACS
ATLS Committee Chair: John P. Sutyak, MD, FACS
ATLS Senior Educator Advisory Board Co-Chair: Gontzal Tamayo, MD, MSc
ATLS Senior Educator Advisory Board Co-Chair: Alicia Ponton-Carss, MD, MSc, PhD
Associate Vice President, Trauma Programs, American College of Surgeons: Jean Clemency
Assistant Director, Trauma Education, American College of Surgeons: Alisa Nagler, JD, MA, EdD
Instructional Design Manager, American College of Surgeons: Julie Cwik, MSEd, MSLIS
Project Manager, American College of Surgeons: Meghan Hogan, DPT
Managing Editor, American College of Surgeons: Tony C. Peregrin
Eleventh Edition
Copyright© 2025 American College of Surgeons 633 N. Saint Clair Street
Chicago, IL 60611-3211
Previous editions copyrighted 1980, 1982, 1984, 1993, 1997, 2004, 2008, 2012, and 2018 by the American College of Surgeons.
Advanced Trauma Life Support® and ATLS® are registered trademarks of the American College of Surgeons.
© 2025 by the American College of Surgeons (ACS), Chicago, IL 60611-3295. All rights reserved. The contents of this publication may
be cited in academic publications, but otherwise may not be reproduced or transmitted in any form by any means without the express
written permission of the ACS. These materials may not be resold nor used to create revenue-generating content by any entity other than
the ACS without the express written permission of the ACS.
RESTRICTED USE: Contents of this publication are strictly prohibited from being uploaded, shared, or incorporated in any third-party
applications, platforms, software, or websites without prior written authorization from the ACS. This restriction explicitly includes, but is
not limited to, the integration of ACS content into tools leveraging artificial intelligence (AI), machine learning, large language models, or
generative AI technologies and infrastructures. Violation of this policy may result in immediate revocation of access, termination of user
accounts, or legal action as deemed appropriate by the ACS.
The American College of Surgeons, its Committee on Trauma, and contributing authors have taken care that the doses of drugs and
recommendations for treatment contained herein are correct and compatible with the standards generally accepted at the time of
publication. However, as new research and clinical experience broaden our knowledge, changes in treatment and drug therapy may become
necessary or appropriate. Readers and participants of this course are advised to check the most current product information provided
by the manufacturer of each drug to be administered to verify the recommended dose, the method and duration of administration, and
contraindications. It is the responsibility of the licensed practitioner to be informed in all aspects of patient care and determine the best
treatment for each individual patient. Note that cervical collars and restriction of spine motion remain the current PHTLS standard in
transporting spine injury patients. If the collars and immobilization devices are to be removed in controlled hospital environments they
should be done so when the stability of the injury is assured. Cervical collars and immobilization devices have been removed in some of
the photos and videos to provide clarity for specific skill demonstrations. The American College of Surgeons, its Committee on Trauma,
and contributing authors disclaim any liability, loss, or damage incurred as a consequence, directly or indirectly, of the use and application
of any of the content of this Tenth Edition of the ATLS Program.
THESE MATERIALS ARE PROVIDED “AS IS” WITH ALL FAULTS, AND ACS DISCLAIMS ANY AND ALL EXPRESS OR IMPLIED
REPRESENTATIONS AND WARRANTIES WITH RESPECT TO THE MATERIALS, INCLUDING ANY EXPRESS OR IMPLIED
WARRANTY OF MERCHANTABILITY, OR FITNESS FOR A PARTICULAR PURPOSE, ACCURACY, OR NON-INFRINGEMENT.
American College of Surgeons.
Printed in the United States of America.
Advanced Trauma Life Support® Course Administration and Faculty Guide Library of Congress Library of Congress Control Number:
2025901684
ii Advanced Trauma Life Support® | 11th Edition
, COURSE MANUAL | Dedication
Dedication
We dedicate this 11th Edition of the Advanced Trauma Life Support (ATLS®) Course to James K. Styner, MD, FACS, who passed away
on January 22, 2024, at his home in Manila, Philippines, at the age of 89 years. Dr. Styner, the developer (along with Paul E. Collicott,
MD, FACS) and pioneer of the ATLS Course, was born on July 22, 1934, in Los Angeles, California, and attended the University of
California–Irvine Medical School, going on to train in orthopaedic surgery. On February 17, 1976, the tragedy which led directly to
the development of the ATLS® Course occurred; Dr. Styner, his wife Charlene, and their four children were returning home to Lincoln,
Nebraska, in a plane piloted by Dr. Styner that crashed in a field in rural Nebraska. Following the crash, Dr. Styner struggled to obtain
appropriate early injury assessment and care for his family in the rural area. He discussed with Dr. Ronald Craig, a family physician
and friend, his concerns about the lack of initial, organized trauma care that he and his children received, to which Dr. Craig famously
replied, “You have to train them before you can blame them.” With that, the concept for a course that would teach the basics of trauma
care was born.
After initial development, the course was subsequently brought into the American College of Surgeons (ACS) as an educational
program in 1980 and was quickly promulgated throughout North America utilizing the regional structure of the Committee on Trauma
(COT). ATLS has now been expanded worldwide, having been translated into more than 10 different languages and currently being
taught to more than 50,000 learners each year in nearly 100 different countries. This 11th Edition of the Advanced Trauma Life Support
Course pays tribute to the early focus on the simultaneous identification and treatment of injuries, while advancing the assessment and
skills training provided through multiple resources and modalities for the ATLS learner. Our thanks to Dr. Styner for showing the world
how to better approach care of the injured patient.
In memory of Dr. Styner and his dedication to trauma education worldwide, the ACS Foundation is accepting donations to the
Trauma Education Fund to help defray the per learner cost of ATLS and other trauma programs in low-resourced areas, and the further
development or translations of educational components for trauma education courses. Please visit www.facs.org/trauma-education-fund
to make a donation.
James K. Styner, MD, FAC
iii
COURSE MANUAL | 11th Edition
Advanced Trauma
Life Support®
(ATLS )®
Standardized Trauma Care
When Seconds Count
,Chair, Committee on Trauma: Jeffrey D. Kerby, MD, PhD, FACS
Medical Director, Committee on Trauma: Eileen M. Bulger, MD, FACS
ATLS Committee Chair: John P. Sutyak, MD, FACS
ATLS Senior Educator Advisory Board Co-Chair: Gontzal Tamayo, MD, MSc
ATLS Senior Educator Advisory Board Co-Chair: Alicia Ponton-Carss, MD, MSc, PhD
Associate Vice President, Trauma Programs, American College of Surgeons: Jean Clemency
Assistant Director, Trauma Education, American College of Surgeons: Alisa Nagler, JD, MA, EdD
Instructional Design Manager, American College of Surgeons: Julie Cwik, MSEd, MSLIS
Project Manager, American College of Surgeons: Meghan Hogan, DPT
Managing Editor, American College of Surgeons: Tony C. Peregrin
Eleventh Edition
Copyright© 2025 American College of Surgeons 633 N. Saint Clair Street
Chicago, IL 60611-3211
Previous editions copyrighted 1980, 1982, 1984, 1993, 1997, 2004, 2008, 2012, and 2018 by the American College of Surgeons.
Advanced Trauma Life Support® and ATLS® are registered trademarks of the American College of Surgeons.
© 2025 by the American College of Surgeons (ACS), Chicago, IL 60611-3295. All rights reserved. The contents of this publication may
be cited in academic publications, but otherwise may not be reproduced or transmitted in any form by any means without the express
written permission of the ACS. These materials may not be resold nor used to create revenue-generating content by any entity other than
the ACS without the express written permission of the ACS.
RESTRICTED USE: Contents of this publication are strictly prohibited from being uploaded, shared, or incorporated in any third-party
applications, platforms, software, or websites without prior written authorization from the ACS. This restriction explicitly includes, but is
not limited to, the integration of ACS content into tools leveraging artificial intelligence (AI), machine learning, large language models, or
generative AI technologies and infrastructures. Violation of this policy may result in immediate revocation of access, termination of user
accounts, or legal action as deemed appropriate by the ACS.
The American College of Surgeons, its Committee on Trauma, and contributing authors have taken care that the doses of drugs and
recommendations for treatment contained herein are correct and compatible with the standards generally accepted at the time of
publication. However, as new research and clinical experience broaden our knowledge, changes in treatment and drug therapy may become
necessary or appropriate. Readers and participants of this course are advised to check the most current product information provided
by the manufacturer of each drug to be administered to verify the recommended dose, the method and duration of administration, and
contraindications. It is the responsibility of the licensed practitioner to be informed in all aspects of patient care and determine the best
treatment for each individual patient. Note that cervical collars and restriction of spine motion remain the current PHTLS standard in
transporting spine injury patients. If the collars and immobilization devices are to be removed in controlled hospital environments they
should be done so when the stability of the injury is assured. Cervical collars and immobilization devices have been removed in some of
the photos and videos to provide clarity for specific skill demonstrations. The American College of Surgeons, its Committee on Trauma,
and contributing authors disclaim any liability, loss, or damage incurred as a consequence, directly or indirectly, of the use and application
of any of the content of this Tenth Edition of the ATLS Program.
THESE MATERIALS ARE PROVIDED “AS IS” WITH ALL FAULTS, AND ACS DISCLAIMS ANY AND ALL EXPRESS OR IMPLIED
REPRESENTATIONS AND WARRANTIES WITH RESPECT TO THE MATERIALS, INCLUDING ANY EXPRESS OR IMPLIED
WARRANTY OF MERCHANTABILITY, OR FITNESS FOR A PARTICULAR PURPOSE, ACCURACY, OR NON-INFRINGEMENT.
American College of Surgeons.
Printed in the United States of America.
Advanced Trauma Life Support® Course Administration and Faculty Guide Library of Congress Library of Congress Control Number:
2025901684
ii Advanced Trauma Life Support® | 11th Edition
, COURSE MANUAL | Dedication
Dedication
We dedicate this 11th Edition of the Advanced Trauma Life Support (ATLS®) Course to James K. Styner, MD, FACS, who passed away
on January 22, 2024, at his home in Manila, Philippines, at the age of 89 years. Dr. Styner, the developer (along with Paul E. Collicott,
MD, FACS) and pioneer of the ATLS Course, was born on July 22, 1934, in Los Angeles, California, and attended the University of
California–Irvine Medical School, going on to train in orthopaedic surgery. On February 17, 1976, the tragedy which led directly to
the development of the ATLS® Course occurred; Dr. Styner, his wife Charlene, and their four children were returning home to Lincoln,
Nebraska, in a plane piloted by Dr. Styner that crashed in a field in rural Nebraska. Following the crash, Dr. Styner struggled to obtain
appropriate early injury assessment and care for his family in the rural area. He discussed with Dr. Ronald Craig, a family physician
and friend, his concerns about the lack of initial, organized trauma care that he and his children received, to which Dr. Craig famously
replied, “You have to train them before you can blame them.” With that, the concept for a course that would teach the basics of trauma
care was born.
After initial development, the course was subsequently brought into the American College of Surgeons (ACS) as an educational
program in 1980 and was quickly promulgated throughout North America utilizing the regional structure of the Committee on Trauma
(COT). ATLS has now been expanded worldwide, having been translated into more than 10 different languages and currently being
taught to more than 50,000 learners each year in nearly 100 different countries. This 11th Edition of the Advanced Trauma Life Support
Course pays tribute to the early focus on the simultaneous identification and treatment of injuries, while advancing the assessment and
skills training provided through multiple resources and modalities for the ATLS learner. Our thanks to Dr. Styner for showing the world
how to better approach care of the injured patient.
In memory of Dr. Styner and his dedication to trauma education worldwide, the ACS Foundation is accepting donations to the
Trauma Education Fund to help defray the per learner cost of ATLS and other trauma programs in low-resourced areas, and the further
development or translations of educational components for trauma education courses. Please visit www.facs.org/trauma-education-fund
to make a donation.
James K. Styner, MD, FAC
iii
