ATLS (Advanced Trauma Life Support) is a generalized protocol for the assessment and management of trauma patients all around the world.

1. Dr. Srijan Roychowdhury
ATLS

2. Learning Objectives
• What is ATLS
• What is the ATLS protocol
• How to Assess, examine and manage a trauma/emergency patient step-by-step
What we should know by the end of this presentation

3. What is ATLS?
Advanced Trauma Life Support
Most widely recognised and practiced
protocol for the management of a trauma
patient worldwide. The protocol
objectives include
A standardized approach to all traumatic
patients.
A comprehensive assessment and
management of patients in emergency
situation.
Best utilization of golden hour which lies
between life and death after a traumatic event.

4. ATLS Protocol
PRIMARY SURVEY
RESUSCITATION
SECONDARY SURVEY
TERTIARY SURVEY

5. PRIMARY
SURVEY
A : AIRWAY and C. Spine
immobilization
B : BREATHING / VENTILATION
C : CIRCULATION &
HEMORRHAGE CONTROL
D : DISABILITY (Neurological
Examination)
E : ENVIRONMENTAL CONTROL
A-B-C-D-E

6. AIRWAY
MANAGEMENT
SUCTIONING OF
NASOPHARYNGEAL AIRWAY
CHIN LIFT
JAW THRUST
ADVANCED
METHODS:
ENDOTRACHEAL INTUBATION
CRICOTHYROIDOTOMY
TRACHEOSTOMY
A
Chin Lift

7. C. SPINE IMMOBILIZATION
Spine should be protected at all times
during management of a trauma patient
• Rigid cervial Collars
• Side head supports
• Long spine boards and straps
• Scoop Stretcher
• Halo Cervical Brace

8. BREATHING AND
VENTILATION
• Expose the chest and assess respiratory
parameters.
• Give Oxygen Inhalation.
• Check Chest wall, Lungs and Diaphragm by
inspection, Percussion, Auscultation.
• Look for conditions that can impair
ventilation.
• Assess Need for Assisted Ventilation.
B

9. CIRCULATION
IMPAIRMENT IN CIRCULATION CAN LEAD
TO SHOCK SO LOOK FOR:
• SKIN COLOUR (PALLOR)
• NARROW PULSE PRESSURE
• HYPOTENSION
• TACHYCARDIA
• LEVEL OF CONSCIOUSNESS
• DIMINISHED URINE OUTPUT
C

10. CONTROL OF
HEMORRHAGE
APPLY DIRECT PRESSURE
PNEUMATIC SPLINTING DEVICES
ACCESS THE NEED FOR SURGICAL INTERVENTION

11. FLUID RESUSCITATION
Double IV lines should be maintained.
Fluids used for resuscitation-
Colloids- Albumin, Dextran, Hydroxyethyl starches (Hetastarch), Gelatin Solutions
Crystalloids- Normal Saline, Ringer’s lactate, 5% Dextrose
Blood Products-
Universal donor O- should be available for immediate use. (Can cause transfusion reactions)
Type Specific Blood (Less chance of transfusion reactions)
Fully cross matched blood (Time Intensive)
3 for 1 rule followed by ATLS- For every ml of blood loss, 3ml fluid should be given as replacement.

12. DISABILITY AND NEUROLOGICAL EXAM
AVPU/GCS
D

13. EXPOSURE and
ENVIRONMENTAL
CONTROL
• UNDRESS COMPLETELY (USE
TRAUMA SCISSORS)
• PREVENT HYPOTHERMIA (
WARM BLANKETS & WARM
FLUIDS)
• EARLY HEMORRHAGE CONTROL
• WARM ROOM TEMPERATURE
SHOULD BE MAINTAINED
E

14. SECONDARY SURVEY
•COMPLETE HISTORY
•COMPLETE HEAD TO TOE EXAMINATION
•REASSESSMENT OF VITAL SIGNS
•COMPLETE NEUROLOGICAL EXAMINATION (GCS)
•SPECIFIC PROCEDURES, SPECIFIC LAB. INVESTIGATIONS
Does not begin until primary survey is over, resuscitation is well under was and patient vitals
are returning to normal

15. DEFINATIVE CARE AND TRANSFER
• ACCORING TO CLINICAL AND OTHER DATA PATIENT IS SHIFTED TO ICU , OT OR OTHERS
RESPECTIVELY.
• OR TRANSFRRED TO OTHER FACILITY ACCORDING TO PATIENT’S NEED OR INSTITUTION’S
CAPABILITY.

16. TERTIARY SURVEY
• DEFINED AS PATIENT’S EVALUATION THAT IDENTIFIES AND CATALOGUES ALL INJURIES AFTR
INITIAL RESUSSITATION AND EMERGENCY OPERATIVE INTERVENTIONS
• PATIENT IS MORE AWAKE .
• MORE INFORMATION ABOUT INJURY IS GATHERED.

17. THANK YOU