Episode 870: Advanced Trauma Life Support (ATLS)

<p dir="ltr"><strong>Contributor: Meghan Hurley MD</strong></p> <p dir="ltr"><strong>Educational Pearls:</strong></p> <p dir="ltr">What is ATLS?</p> <ul> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Advanced Trauma Life Support (ATLS) is a systematic and comprehensive approach to the evaluation and management of trauma patients</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">It was developed by the American College of Surgeons (ACS)</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">The key components include the Primary Survey ("ABCDE"), the Secondary Survey, Definitive Care, and Special Considerations</p> </li> </ul> <p dir="ltr">What are the issues with ATLS?</p> <ul> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">ATLS relies on many algorithms and rules-of-thumb, which might be helpful for individuals with basic skills and training but might actually present obstacles for those with higher levels of training. Dr. Hurley cites several examples.</p> </li> </ul> <p dir="ltr">Example 1: ABC approach to trauma patients</p> <ul> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">ABC stands for Airway, Breathing, and Circulation but focusing on the airway first is not always the best decision.</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Immediate attention may need to be applied to massive hemorrhage.</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Intubating a patient that is hemodynamically unstable may cause cardiac arrest.</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">A more helpful phrase might be “Resuscitate before you intubate.”</p> </li> </ul> <p dir="ltr">Example 2: C-spine precautions</p> <ul> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Cervical collars may impede the likelihood of first-pass success when intubating. The risk of complications from a failed airway may often outweigh the risk of causing a spinal cord