OBJECTIVE
ATLS
PREPARATION
PREHOSPITAL PHASE
HOSPITAL PHASE
PREHOSPITAL PHASE:
Coordination with the prehospital agency and personel
can greatly fasten the treatment in the field. They inform
the receiving hospital which mobilizes the trauma team to
ED.
HOSPITAL PHASE
Advance planning for the trauma pt. beneficial. It saves
time.
TRIAGE
The process of categorizing victims or mass
casualties based on their need for treatment
and the resources available.
ITS MAIN GOALS ARE.
Prevent avoidable deaths.
Ensure proper initial treatment with a
minimal time frame.
Avoid misusing assests on hopeless cases.
Multiple casualties
MASS CASUALTIES
PRIMARY SURVEY
What is the quick ,simple way to assess
the trauma patient in 10 seconds?
A comlete sentence spoken by pt. tells us:
1.
2.
3.
Airway is patent.
Breathing intact.
Good cerebral circulation.
Simple maneuvers
Chin lift
Jaw thrust
Suction
Oropharyngeal and nasopharyngeal
airway
Laryngeal mask airway
Laryngeal tube airway
Gum elastic bougie.
Definitive airway
Surgical airway.
UNCONCIOUS
GCS <8
RISK OF ASPIRATION
RISK OF IMPENDING OBSTRUCTION.
BREATHING
Inspection
Auscultation
Palpation
Percussion
maneuvers
Assess for:
Shock
External bleeding
Occult bleeding
Estimate the blood loss on initial
presentation of patient and the signs and
symptoms
Replace fluid accordingly, 2 litres of
warm crystalloid solution.
DISABILITY
GCS
PUpillary reaction and size
EXPOSURE
Undress the patient completely but
prevent hypothermia.
Logrolling and looking for back of the pt.
is very important.
ECG
PULSE OXIMETRY
Xray chest AP view
Xray pelvis AP view
URINARY CATHETER
GASTRIC CATHETER
BLOOD PRESSURE
ABGS
FAST
DPL
NEED TO TRANSFER or
REFER?
SECONDARY SURVEY
Secondary survey does not begin until the primary survey is
completed,resuscitative efforts are established and patient
is demonstrating normalization of vital functions.
It includes:
Head to toe evaluation
AMPLE history
Allergy
Medications currently taking
Past illness
Last meal
Event/environment related to injury.
physical examination
Reassessment of all vital organs.
Adjucts to secondary
survey
CT SCAN
CONTRAST STUDIES
EXTREMITY XRAY
ENDOSCOPY
ULTRASONOGRAPHY
DEFINATIVE CARE
ABCDE APPROACH.
TREAT GREATEST THREAT TO LIFE.
DEFINITIVE DIAGNOSIS IS NOT
IMMEDIATELY IMPORTANT.
TIME IS THE ESSENCE.
DO NO FURTHER HARM THE
PATIENT
CASE
A 20 year old woman is found trapped in
her automobile. Several hours are
required to extricate her because her leg
was trapped and twisted beneath the
dash board. In the hospital she is
hemodynamically unstable with pulse of
120bpm, r/r 14, bp 80mmhg systolic
only, she has a large wound in her left
leg which is bleeding profusely..