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ATLS and Trauma management 2024
ATLS and Trauma management 2024
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ATLS and Trauma management 2024Advanced Trauma Life Support, or ATLS for short, is a: - ANS-concise approach to
assessing and managing the multiply injured patient...which hopes to reduce the
morbidity and mortality related to trauma
Most deaths after injury occur in one of three time periods: - ANS-at the time of injury or
within 60 minutes, within the following few hours, or several days / weeks after the
injury.
ATLS focuses on the first___________ following injury the - ANS-"Golden Hour"
What are the stages of ATLS? - ANS-- preparation before the patient has even arrived.
-On arrival the primary survey and resuscitation should begin. This targets the most life
threatening problems.
-After this an AMPLE history and secondary survey should be completed. - your work
is not done until after continued monitoring and the patient is transferred for further
management or discharged.
Which people make up a trauma team? - ANS--Two team leaders - One doctor and one
nurse.
-One "airway" doctor and one "airway" nurse, plus two "circulation" doctors and two
"circulation" nurses
-A "relatives" nurse
-A radiographer
In order to prepare appropriately you need to know what to expect before the casualty
arrives so you contact the crew while they are in transit.
So what should you ask the ambulance crew? - ANS-"What type of incident is it?" e.g.
car crash, chemical spill
"How many casualties are there?"
"What are their ages and sexes?"
"What is the status of the casualties" e.g. ABC - airway, breathing, circulation and
, conscious level (GCS).
"What treatment have you given so far and what were the effects?"
"Estimated time of arrival?" ("ETA" if you want to sound like you're on ER.)
A is for Airway and cervical spine protection.
What is the ASSESMENT? - ANS-Check airway patency whilst manually stabilising the
C-spine (if not already in collar/blocks/tape)
A is for Airway and cervical spine protection. What is the MANAGEMENT (if not
patent)? - ANS-Perform a Jaw Thrust. (not a head tilt/chin lift which will move the
C-spine)
Clear foreign bodies e.g. fractures, dentures, chewing gum.
Insert an oropharyngeal or nasopharyngeal airway if required.
If necessary establish a definitive airway by orotracheal or surgical cricothyroidotomy.
Protect the cervical spine as above.
When would you intubate a patient? - ANS-Ventilation during anaesthetic surgery, if
muscle relaxant is required, patient cant protect the airway (GCS <8, aspiration risk,
muscle relaxant)
Potential airway obstruction (burns, trauma, neck haemotoma, inadequate
ventilation/oxygenation (COPD, head injury, ARDS)
B is for Breathing and ventilation, ASSESSMENT? - ANS-Expose the neck and chest
(while keeping the cervical spine immobilised)
What is the rate and depth of the patient's respirations?
Inspect, Palpate, Percuss and Auscultate the neck and chest.
Look for a tension pneumothorax, flail chest, pulmonary contusion, massive
haemothorax and an open pneumothorax.
MANAGEMENT of a Tension Pneumothorax - ANS-MANAGEMENT - Give
15l/min oxygen through a tight fitting non-rebreathing, reservoir mask
- Put on the pulse oximeter
- Immediately treat a tension pneumothorax (Thorencentisis mid clavicular line, 2nd
intercostal space, Wide bore cannula 14/16 bore)
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