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

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

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

PRIMARY SURVEY

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

C - CIRCULATION

Examine for signs of

shock:

- Tachycardia

- Diminished pulse

- Pallor

- Reduce CPR

C - CIRCULATION

- Insert 2 large

bore branula

- Send for blood!

- Transfuse!

D – DISABILITY

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

THANK YOU!