The ATLS
concept
GENERAL MANAGEMENT
OF TRAUMA
A serious injury to the body that maybe life-threatening
Malaysia – mainly from MVA
WHAT IS TRAUMA?
Prevent death
Mainly second
peak of death
GOLDEN HOUR!
AIM OF MANAGEMENT
Pre – hospital
Triage
Hospital m(x) - ATLS
STEPS IN MANAGEMENT
PRE-HOSPITAL
Comprehensive on site
management
PRE-HOSPITAL
‘Scoop and run’ concept!
A system to sort cases based on priority especially in mass
disasters
Many don’t understand leading to complaints (6 hour UMMC)
TRIAGE
Introduced by Ortho
surgeon
Treat the life-threatening
condition first
Approach trauma in an
organized and sequential
manner
Internationally recognized
HOSPITAL M(X) - ATLS CONCEPT
Rapid assessment and treatment of life-threatening injuries
PRIMARY SURVEY
A •Airway (with c-spine)
B •Breathing
C •Circulation
D •Disability
E •Exposure
A – AIRWAY (WITH C-SPINE)
A – AIRWAY (WITH C-SPINE)
A – AIRWAY (WITH C-SPINE)
Oropharyngeal airway
A – AIRWAY (WITH C-SPINE)
A clear airway does not mean the patient
is breathing adequately
Is required to provide adequate tissue
oxygenation
Once airway secure, a complete
examination of the lungs MUST be done
B - BREATHING
B - BREATHING
• LOOK
• LISTEN
• FEEL
B - BREATHING
LOOK
ANY TACHYPNEA?
B - BREATHING
LISTEN
Abnormal or absent breath sounds
B - BREATHING
FEEL
Perform percussion:
Looking for hyper resonance or
dullness
B - BREATHING
Tracheal palpation:
Looking for deviation
B - BREATHING
TENSION
PNEUMOTHORAX:
- No chest excursion
- Absent breath
sounds
- Hyper resonance
- Tracheal deviation
away
C - CIRCULATION
Examine for signs of
shock:
- Tachycardia
- Diminished pulse
- Pallor
- Reduce CPR
C - CIRCULATION
- Insert 2 large
bore branula
- Send for blood!
- Transfuse!
E - EXPOSURE
- Not to miss
anything
- Ensure not
hypothermic
History
Complete physical examination
‘tubes and fingers in every
orifice’
Neurological examination
Re-evaluation
SECONDARY SURVEY