SlideShare a Scribd company logo
1 of 50
Advanced Trauma Life Support ® , 8 th  Edition,  The Evidence for Change Volume 64(6). June 2008.1638-1650 http://decode-medicine.blogspot.com/ summarized by sun yaicheng
History ,[object Object],Doctor James K. Styner
ATLS ®  Program Overview ,[object Object],[object Object],[object Object],[object Object],[object Object]
A Brief Summary of Wright et al. Levels of Evidence. JBJS(A) Treatment  Prognosis  Diagnosis  Economic and Decision analysis  Level of Evidence 1 RCT with significant difference or narrow confidence intervals Prospective study with single inception cohort and 80% follow-up Testing of previously  applied diagnostic criteria in a consecutive series against a gold standard Clinically sensible costs and alternatives; values obtained from many studies; multiway sensitivity analyses Systematic reviews of level 1 studies Systematic review of level 1 studies Systematic review of level 1 studies Systematic review of level 1 studies 2 Prospective cohort, poor quality RCT Retrospective study, untreated controls from a previous RCT Development of  diagnostic criteria on basis of consecutive patients against a gold standard Clinically sensible costs and alternatives, values cobtained from limited studies, multiway sensitivity analyses Systematic reviews of level 2 studies Systematic review of level 2 studies Systematic review of level 2 studies Systematic review of level 2 studies 3 Case–control study Study of nonconsecutive patients (no consistently applied gold standard) Limited alternatives and costs; poor estimates Retrospective cohort study Systematic review of level 3 studies Systematic review of level 3 studies Systematic review of level 3 studies 4 Case series Case series Case–control study Poor reference standard No sensitivity analyses 5 Expert opinion Expert opinion Expert opinion Expert opinion
Initial assessment
Rectal examination ,[object Object],[object Object],[object Object],[object Object]
Airway
Carbon dioxide detectors ,[object Object],[object Object],[object Object],[object Object]
Laryngeal mask airway (LMA) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Laryngeal tube airway (LTA) ,[object Object],[object Object],[object Object],[object Object],[object Object]
Gum Elastic Bougie ,[object Object],[object Object],[object Object],[object Object],[object Object]
Difficult airway ,[object Object],[object Object],[object Object],[object Object],[object Object]
Shock
Crystalloid ,[object Object],[object Object],[object Object],[object Object],[object Object]
Fluid resuscitation ,[object Object],[object Object]
Fluid resuscitation ,[object Object],[object Object],[object Object],[object Object]
Fluid resuscitation ,[object Object],[object Object],[object Object],[object Object]
Angio-embolization and  definitive control of hemorrhage ,[object Object],[object Object],[object Object],[object Object]
Treatment of cardiac  tamponade ,[object Object],[object Object],[object Object],[object Object],[object Object]
Base deficit & lactate ,[object Object],[object Object],[object Object],[object Object]
Thoracic trauma
Treatment of pneumothorax ,[object Object],[object Object],[object Object],[object Object]
ED thoracotomy ,[object Object],[object Object],[object Object]
ED thoracotomy  ,[object Object],[object Object],[object Object],[object Object]
Blunt traumatic aortic injury ,[object Object],[object Object],[object Object],[object Object]
Abdomen
Explosive devices ,[object Object],[object Object],[object Object],[object Object]
Hemo-dynamically abnormal pelvic fractures ,[object Object],[object Object],[object Object],[object Object],[object Object]
Head trauma
Classification and head CT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Canadian CT Head Rule for patients with minor head injury ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Lancet. 2001 May 5;357(9266):1391-6.
Penetrating brain injury ,[object Object],[object Object],[object Object],[object Object]
Penetrating brain injury ,[object Object],[object Object],[object Object],[object Object]
Spine
Blunt carotid and vertebral vascular injuries (BCVI) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Steroids ,[object Object],[object Object],[object Object],[object Object]
CT evaluation of the cervical spine ,[object Object],[object Object],[object Object],[object Object]
Atlantooccipital dislocation ,[object Object],[object Object],[object Object],[object Object],Power's Ratio:   A = C1 anterior arch,  B = basion (anterior margin of foramen magnum),  C = anterior portion of the posterior ring of C1,  O = opsthion (posterior margin of foramen magnum).  If BC/AO greater than 1,  anterior occipitoatlantal dislocation exists.
Power’s ratio to diagnose AOD shown on plain radiographs and CT scans of a patient without injury From:  Dziurzynski: Spine, Volume 30(12). June 15, 2005.1427-1432
Musculoskeletal trauma and extremity trauma
Tourniquet ,[object Object],[object Object],[object Object],[object Object]
Compartment syndrome ,[object Object],[object Object],[object Object],[object Object]
Trauma in women
Restraints ,[object Object],[object Object],[object Object],[object Object]
Airbags ,[object Object],[object Object],[object Object],[object Object]
Pediatric trauma
Functional outcome ,[object Object],[object Object],[object Object],[object Object]
Abdominal imaging CT ,[object Object],[object Object],[object Object],[object Object]
Abdominal imaging FAST ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Abdominal bruising ,[object Object],[object Object],[object Object],[object Object]

More Related Content

What's hot

Initial Assessment And Management
Initial Assessment And ManagementInitial Assessment And Management
Initial Assessment And Managementkk 555888
 
ATLS 9E Major Changes
ATLS 9E Major ChangesATLS 9E Major Changes
ATLS 9E Major ChangesSun Yai-Cheng
 
Disaster Triage START and SAVE
Disaster Triage START and SAVEDisaster Triage START and SAVE
Disaster Triage START and SAVECarl Schultz
 
Fluid management in icu dr vijay
Fluid management in icu dr vijayFluid management in icu dr vijay
Fluid management in icu dr vijayVijay Kumar
 
Initial Assessment and Management for Trauma
Initial Assessment and Management for TraumaInitial Assessment and Management for Trauma
Initial Assessment and Management for TraumaPaleenui Jariyakanjana
 
Advanced trauma life support
Advanced trauma life supportAdvanced trauma life support
Advanced trauma life supportyakubuahmed1
 
2022 high performance cpr update
2022 high performance cpr update2022 high performance cpr update
2022 high performance cpr updateRobert Cole
 
Approach to patients with polytrauma
Approach to patients with polytraumaApproach to patients with polytrauma
Approach to patients with polytraumaAwaneesh Katiyar
 
ADVANCED TRAUMA LIFE SUPPORT.pdf
ADVANCED TRAUMA LIFE SUPPORT.pdfADVANCED TRAUMA LIFE SUPPORT.pdf
ADVANCED TRAUMA LIFE SUPPORT.pdfShapi. MD
 
Update on Fluid Resuscitation
Update on Fluid ResuscitationUpdate on Fluid Resuscitation
Update on Fluid ResuscitationKristopher Maday
 
Atls tenth ed initial mm
Atls tenth ed initial mmAtls tenth ed initial mm
Atls tenth ed initial mmimran80
 
Atls; Advanced Trauma Life Support
Atls; Advanced Trauma Life SupportAtls; Advanced Trauma Life Support
Atls; Advanced Trauma Life SupportFaisalRawagah1
 
Advanced trauma life support (atls)
Advanced trauma life support (atls)Advanced trauma life support (atls)
Advanced trauma life support (atls)Adeel Riaz
 
Post Cardiac Arrest Syndrome
Post Cardiac Arrest SyndromePost Cardiac Arrest Syndrome
Post Cardiac Arrest SyndromeSun Yai-Cheng
 
Perioperative fluid therapy
Perioperative fluid therapyPerioperative fluid therapy
Perioperative fluid therapyspecialclass
 
Initial assessment and management of trauma
Initial assessment and management of traumaInitial assessment and management of trauma
Initial assessment and management of traumaVASS Yukon
 
Post–Cardiac Arrest Care
Post–Cardiac Arrest CarePost–Cardiac Arrest Care
Post–Cardiac Arrest CareSun Yai-Cheng
 
Trauma mangement
Trauma mangementTrauma mangement
Trauma mangementNidhi
 

What's hot (20)

Initial Assessment And Management
Initial Assessment And ManagementInitial Assessment And Management
Initial Assessment And Management
 
ATLS 9E Major Changes
ATLS 9E Major ChangesATLS 9E Major Changes
ATLS 9E Major Changes
 
Disaster Triage START and SAVE
Disaster Triage START and SAVEDisaster Triage START and SAVE
Disaster Triage START and SAVE
 
Introduction To ATLS
Introduction To ATLSIntroduction To ATLS
Introduction To ATLS
 
Fluid management in icu dr vijay
Fluid management in icu dr vijayFluid management in icu dr vijay
Fluid management in icu dr vijay
 
Initial Assessment and Management for Trauma
Initial Assessment and Management for TraumaInitial Assessment and Management for Trauma
Initial Assessment and Management for Trauma
 
Advanced trauma life support
Advanced trauma life supportAdvanced trauma life support
Advanced trauma life support
 
2022 high performance cpr update
2022 high performance cpr update2022 high performance cpr update
2022 high performance cpr update
 
Approach to patients with polytrauma
Approach to patients with polytraumaApproach to patients with polytrauma
Approach to patients with polytrauma
 
Prinary survey ATLS
Prinary survey ATLSPrinary survey ATLS
Prinary survey ATLS
 
ADVANCED TRAUMA LIFE SUPPORT.pdf
ADVANCED TRAUMA LIFE SUPPORT.pdfADVANCED TRAUMA LIFE SUPPORT.pdf
ADVANCED TRAUMA LIFE SUPPORT.pdf
 
Update on Fluid Resuscitation
Update on Fluid ResuscitationUpdate on Fluid Resuscitation
Update on Fluid Resuscitation
 
Atls tenth ed initial mm
Atls tenth ed initial mmAtls tenth ed initial mm
Atls tenth ed initial mm
 
Atls; Advanced Trauma Life Support
Atls; Advanced Trauma Life SupportAtls; Advanced Trauma Life Support
Atls; Advanced Trauma Life Support
 
Advanced trauma life support (atls)
Advanced trauma life support (atls)Advanced trauma life support (atls)
Advanced trauma life support (atls)
 
Post Cardiac Arrest Syndrome
Post Cardiac Arrest SyndromePost Cardiac Arrest Syndrome
Post Cardiac Arrest Syndrome
 
Perioperative fluid therapy
Perioperative fluid therapyPerioperative fluid therapy
Perioperative fluid therapy
 
Initial assessment and management of trauma
Initial assessment and management of traumaInitial assessment and management of trauma
Initial assessment and management of trauma
 
Post–Cardiac Arrest Care
Post–Cardiac Arrest CarePost–Cardiac Arrest Care
Post–Cardiac Arrest Care
 
Trauma mangement
Trauma mangementTrauma mangement
Trauma mangement
 

Viewers also liked

ATLS (Advance Trauma Life Support)
ATLS (Advance Trauma Life Support)ATLS (Advance Trauma Life Support)
ATLS (Advance Trauma Life Support)Aamirr Xeb
 
Advanced trauma life support
Advanced trauma life supportAdvanced trauma life support
Advanced trauma life supportSunil Poonia
 
Atls advanced_trauma_life_support_for_doctors_eighth_edition
Atls  advanced_trauma_life_support_for_doctors_eighth_editionAtls  advanced_trauma_life_support_for_doctors_eighth_edition
Atls advanced_trauma_life_support_for_doctors_eighth_editionQasim Irshad
 
advanced trauma life support
advanced trauma life supportadvanced trauma life support
advanced trauma life supportSitanshu Barik
 

Viewers also liked (11)

ATLS (Advance Trauma Life Support)
ATLS (Advance Trauma Life Support)ATLS (Advance Trauma Life Support)
ATLS (Advance Trauma Life Support)
 
Resuscitation
ResuscitationResuscitation
Resuscitation
 
Trauma
Trauma  Trauma
Trauma
 
Advanced trauma life support
Advanced trauma life supportAdvanced trauma life support
Advanced trauma life support
 
Duodenal injuries
Duodenal injuriesDuodenal injuries
Duodenal injuries
 
Critical care units
Critical care unitsCritical care units
Critical care units
 
Trauma
TraumaTrauma
Trauma
 
Serial numbers
Serial numbersSerial numbers
Serial numbers
 
Atls advanced_trauma_life_support_for_doctors_eighth_edition
Atls  advanced_trauma_life_support_for_doctors_eighth_editionAtls  advanced_trauma_life_support_for_doctors_eighth_edition
Atls advanced_trauma_life_support_for_doctors_eighth_edition
 
Atls quemados
Atls quemadosAtls quemados
Atls quemados
 
advanced trauma life support
advanced trauma life supportadvanced trauma life support
advanced trauma life support
 

Similar to ATLS 8e, The Evidence for Change

ATLS Protocol.pptx
ATLS Protocol.pptxATLS Protocol.pptx
ATLS Protocol.pptxssuser728a21
 
Management of major traumaMAIN.pptx
Management of major traumaMAIN.pptxManagement of major traumaMAIN.pptx
Management of major traumaMAIN.pptxrijjorajoo
 
Thrombolysis of thrombosed prosthetic heart valve
Thrombolysis of thrombosed prosthetic heart valveThrombolysis of thrombosed prosthetic heart valve
Thrombolysis of thrombosed prosthetic heart valveRamachandra Barik
 
Shock in Trauma.pptx
Shock in Trauma.pptxShock in Trauma.pptx
Shock in Trauma.pptxprabhatbhati3
 
Hemocron Elite: A Comparative study of Anticoagulation Monitoring Tests in Tr...
Hemocron Elite: A Comparative study of Anticoagulation Monitoring Tests in Tr...Hemocron Elite: A Comparative study of Anticoagulation Monitoring Tests in Tr...
Hemocron Elite: A Comparative study of Anticoagulation Monitoring Tests in Tr...Karounka Keita M.S. CCP/LP
 
Comparison of transfusion requirements between open and robotic assisted lapa...
Comparison of transfusion requirements between open and robotic assisted lapa...Comparison of transfusion requirements between open and robotic assisted lapa...
Comparison of transfusion requirements between open and robotic assisted lapa...anemo_site
 
THE LATEST IN STROKE MANAGEMENT, ACUTE AND PREVENTIVE By Arlyn Valencia, M.D....
THE LATEST IN STROKE MANAGEMENT, ACUTE AND PREVENTIVE By Arlyn Valencia, M.D....THE LATEST IN STROKE MANAGEMENT, ACUTE AND PREVENTIVE By Arlyn Valencia, M.D....
THE LATEST IN STROKE MANAGEMENT, ACUTE AND PREVENTIVE By Arlyn Valencia, M.D....Arlyn Valencia, M.D.
 
Pulmonary Embolism lecture 2022
Pulmonary Embolism lecture 2022Pulmonary Embolism lecture 2022
Pulmonary Embolism lecture 2022Dr.Marwan Sneymeh
 
2012 blood d&t-weltert-blood-sparing heart surgery
2012 blood d&t-weltert-blood-sparing heart surgery2012 blood d&t-weltert-blood-sparing heart surgery
2012 blood d&t-weltert-blood-sparing heart surgeryanemo_site
 

Similar to ATLS 8e, The Evidence for Change (20)

A T L S
A T L SA T L S
A T L S
 
Gcs
GcsGcs
Gcs
 
Advance trauma life support uptodate 2019
Advance trauma life support uptodate 2019Advance trauma life support uptodate 2019
Advance trauma life support uptodate 2019
 
ATLS Protocol.pptx
ATLS Protocol.pptxATLS Protocol.pptx
ATLS Protocol.pptx
 
Management of major traumaMAIN.pptx
Management of major traumaMAIN.pptxManagement of major traumaMAIN.pptx
Management of major traumaMAIN.pptx
 
trauma.pptx
trauma.pptxtrauma.pptx
trauma.pptx
 
Cardiac arrest in special populations - Emerg Med Clin N Am 2011
Cardiac arrest in special populations - Emerg Med Clin N Am 2011Cardiac arrest in special populations - Emerg Med Clin N Am 2011
Cardiac arrest in special populations - Emerg Med Clin N Am 2011
 
Thrombolysis of thrombosed prosthetic heart valve
Thrombolysis of thrombosed prosthetic heart valveThrombolysis of thrombosed prosthetic heart valve
Thrombolysis of thrombosed prosthetic heart valve
 
Shock in Trauma.pptx
Shock in Trauma.pptxShock in Trauma.pptx
Shock in Trauma.pptx
 
Presentacion
PresentacionPresentacion
Presentacion
 
Presentacion
PresentacionPresentacion
Presentacion
 
Hemocron Elite: A Comparative study of Anticoagulation Monitoring Tests in Tr...
Hemocron Elite: A Comparative study of Anticoagulation Monitoring Tests in Tr...Hemocron Elite: A Comparative study of Anticoagulation Monitoring Tests in Tr...
Hemocron Elite: A Comparative study of Anticoagulation Monitoring Tests in Tr...
 
Comparison of transfusion requirements between open and robotic assisted lapa...
Comparison of transfusion requirements between open and robotic assisted lapa...Comparison of transfusion requirements between open and robotic assisted lapa...
Comparison of transfusion requirements between open and robotic assisted lapa...
 
THE LATEST IN STROKE MANAGEMENT, ACUTE AND PREVENTIVE By Arlyn Valencia, M.D....
THE LATEST IN STROKE MANAGEMENT, ACUTE AND PREVENTIVE By Arlyn Valencia, M.D....THE LATEST IN STROKE MANAGEMENT, ACUTE AND PREVENTIVE By Arlyn Valencia, M.D....
THE LATEST IN STROKE MANAGEMENT, ACUTE AND PREVENTIVE By Arlyn Valencia, M.D....
 
Pulmonary Embolism lecture 2022
Pulmonary Embolism lecture 2022Pulmonary Embolism lecture 2022
Pulmonary Embolism lecture 2022
 
BETHWELL
BETHWELLBETHWELL
BETHWELL
 
Cardiac surgery and ptca
Cardiac surgery and ptcaCardiac surgery and ptca
Cardiac surgery and ptca
 
Blunt trauma abdomen
Blunt trauma abdomenBlunt trauma abdomen
Blunt trauma abdomen
 
Managing complications v4
Managing complications v4Managing complications v4
Managing complications v4
 
2012 blood d&t-weltert-blood-sparing heart surgery
2012 blood d&t-weltert-blood-sparing heart surgery2012 blood d&t-weltert-blood-sparing heart surgery
2012 blood d&t-weltert-blood-sparing heart surgery
 

More from Sun Yai-Cheng

COVID-19 (Coronavirus disease 2019), part 2
COVID-19 (Coronavirus disease 2019), part 2COVID-19 (Coronavirus disease 2019), part 2
COVID-19 (Coronavirus disease 2019), part 2Sun Yai-Cheng
 
COVID-19 (Coronavirus disease 2019) update
COVID-19 (Coronavirus disease 2019) updateCOVID-19 (Coronavirus disease 2019) update
COVID-19 (Coronavirus disease 2019) updateSun Yai-Cheng
 
Initial Care of the Severely Injured Patient
Initial Care of the Severely Injured PatientInitial Care of the Severely Injured Patient
Initial Care of the Severely Injured PatientSun Yai-Cheng
 
Management of Heart Failure in ED
Management of Heart Failure in EDManagement of Heart Failure in ED
Management of Heart Failure in EDSun Yai-Cheng
 
2018 Stroke Guidelines
2018 Stroke Guidelines2018 Stroke Guidelines
2018 Stroke GuidelinesSun Yai-Cheng
 
DAWN and DEFUSE 3 trial
DAWN and DEFUSE 3 trialDAWN and DEFUSE 3 trial
DAWN and DEFUSE 3 trialSun Yai-Cheng
 
The European Guideline on Management of Major Bleeding and Coagulopathy Follo...
The European Guideline on Management of Major Bleeding and Coagulopathy Follo...The European Guideline on Management of Major Bleeding and Coagulopathy Follo...
The European Guideline on Management of Major Bleeding and Coagulopathy Follo...Sun Yai-Cheng
 
Surviving Sepsis Guidelines 2016
Surviving Sepsis Guidelines 2016Surviving Sepsis Guidelines 2016
Surviving Sepsis Guidelines 2016Sun Yai-Cheng
 
VBG or ABG analysis in Emergency Care?
VBG or ABG analysis in Emergency Care?VBG or ABG analysis in Emergency Care?
VBG or ABG analysis in Emergency Care?Sun Yai-Cheng
 
Top 10 Myths Regarding the Diagnosis and Treatment of UTI
Top 10 Myths Regarding the Diagnosis and Treatment of UTITop 10 Myths Regarding the Diagnosis and Treatment of UTI
Top 10 Myths Regarding the Diagnosis and Treatment of UTISun Yai-Cheng
 
ACEP Policy for Fever Infants and Children Younger than 2 Years of Age in ED
ACEP Policy for Fever Infants and Children Younger than 2 Years of Age in EDACEP Policy for Fever Infants and Children Younger than 2 Years of Age in ED
ACEP Policy for Fever Infants and Children Younger than 2 Years of Age in EDSun Yai-Cheng
 
Focused Cardiac Ultrasound
Focused Cardiac UltrasoundFocused Cardiac Ultrasound
Focused Cardiac UltrasoundSun Yai-Cheng
 
2015 AHA CPR & ECC 更新重點提要
2015 AHA CPR & ECC 更新重點提要2015 AHA CPR & ECC 更新重點提要
2015 AHA CPR & ECC 更新重點提要Sun Yai-Cheng
 
2015 AHA/ASA Focused Update Guidelines for Acute Ischemic Stroke Regarding En...
2015 AHA/ASA Focused Update Guidelines for Acute Ischemic Stroke Regarding En...2015 AHA/ASA Focused Update Guidelines for Acute Ischemic Stroke Regarding En...
2015 AHA/ASA Focused Update Guidelines for Acute Ischemic Stroke Regarding En...Sun Yai-Cheng
 
Best Mobile Medical Apps in ED
Best Mobile Medical Apps in EDBest Mobile Medical Apps in ED
Best Mobile Medical Apps in EDSun Yai-Cheng
 
Use of tPA for the Management of Acute Ischemic Stroke in the ED: ACEP Policy
Use of tPA for the Management of Acute Ischemic Stroke in the ED: ACEP PolicyUse of tPA for the Management of Acute Ischemic Stroke in the ED: ACEP Policy
Use of tPA for the Management of Acute Ischemic Stroke in the ED: ACEP PolicySun Yai-Cheng
 
Evaluation and Management of Acute Aortic Dissection: ACEP Policy
Evaluation and Management of  Acute Aortic Dissection: ACEP PolicyEvaluation and Management of  Acute Aortic Dissection: ACEP Policy
Evaluation and Management of Acute Aortic Dissection: ACEP PolicySun Yai-Cheng
 
C-Spine Collar Clearance In The Obtunded Adult Blunt Trauma Patient
C-Spine Collar Clearance In The Obtunded Adult Blunt Trauma PatientC-Spine Collar Clearance In The Obtunded Adult Blunt Trauma Patient
C-Spine Collar Clearance In The Obtunded Adult Blunt Trauma PatientSun Yai-Cheng
 
ASA Guidelines for Management of the Difficult Airway
ASA Guidelines for Management of the Difficult AirwayASA Guidelines for Management of the Difficult Airway
ASA Guidelines for Management of the Difficult AirwaySun Yai-Cheng
 

More from Sun Yai-Cheng (20)

COVID-19 (Coronavirus disease 2019), part 2
COVID-19 (Coronavirus disease 2019), part 2COVID-19 (Coronavirus disease 2019), part 2
COVID-19 (Coronavirus disease 2019), part 2
 
COVID-19 (Coronavirus disease 2019) update
COVID-19 (Coronavirus disease 2019) updateCOVID-19 (Coronavirus disease 2019) update
COVID-19 (Coronavirus disease 2019) update
 
Initial Care of the Severely Injured Patient
Initial Care of the Severely Injured PatientInitial Care of the Severely Injured Patient
Initial Care of the Severely Injured Patient
 
Management of Heart Failure in ED
Management of Heart Failure in EDManagement of Heart Failure in ED
Management of Heart Failure in ED
 
2018 Stroke Guidelines
2018 Stroke Guidelines2018 Stroke Guidelines
2018 Stroke Guidelines
 
DAWN and DEFUSE 3 trial
DAWN and DEFUSE 3 trialDAWN and DEFUSE 3 trial
DAWN and DEFUSE 3 trial
 
The European Guideline on Management of Major Bleeding and Coagulopathy Follo...
The European Guideline on Management of Major Bleeding and Coagulopathy Follo...The European Guideline on Management of Major Bleeding and Coagulopathy Follo...
The European Guideline on Management of Major Bleeding and Coagulopathy Follo...
 
Surviving Sepsis Guidelines 2016
Surviving Sepsis Guidelines 2016Surviving Sepsis Guidelines 2016
Surviving Sepsis Guidelines 2016
 
VBG or ABG analysis in Emergency Care?
VBG or ABG analysis in Emergency Care?VBG or ABG analysis in Emergency Care?
VBG or ABG analysis in Emergency Care?
 
Top 10 Myths Regarding the Diagnosis and Treatment of UTI
Top 10 Myths Regarding the Diagnosis and Treatment of UTITop 10 Myths Regarding the Diagnosis and Treatment of UTI
Top 10 Myths Regarding the Diagnosis and Treatment of UTI
 
ACEP Policy for Fever Infants and Children Younger than 2 Years of Age in ED
ACEP Policy for Fever Infants and Children Younger than 2 Years of Age in EDACEP Policy for Fever Infants and Children Younger than 2 Years of Age in ED
ACEP Policy for Fever Infants and Children Younger than 2 Years of Age in ED
 
Focused Cardiac Ultrasound
Focused Cardiac UltrasoundFocused Cardiac Ultrasound
Focused Cardiac Ultrasound
 
ACLS 2015
ACLS 2015ACLS 2015
ACLS 2015
 
2015 AHA CPR & ECC 更新重點提要
2015 AHA CPR & ECC 更新重點提要2015 AHA CPR & ECC 更新重點提要
2015 AHA CPR & ECC 更新重點提要
 
2015 AHA/ASA Focused Update Guidelines for Acute Ischemic Stroke Regarding En...
2015 AHA/ASA Focused Update Guidelines for Acute Ischemic Stroke Regarding En...2015 AHA/ASA Focused Update Guidelines for Acute Ischemic Stroke Regarding En...
2015 AHA/ASA Focused Update Guidelines for Acute Ischemic Stroke Regarding En...
 
Best Mobile Medical Apps in ED
Best Mobile Medical Apps in EDBest Mobile Medical Apps in ED
Best Mobile Medical Apps in ED
 
Use of tPA for the Management of Acute Ischemic Stroke in the ED: ACEP Policy
Use of tPA for the Management of Acute Ischemic Stroke in the ED: ACEP PolicyUse of tPA for the Management of Acute Ischemic Stroke in the ED: ACEP Policy
Use of tPA for the Management of Acute Ischemic Stroke in the ED: ACEP Policy
 
Evaluation and Management of Acute Aortic Dissection: ACEP Policy
Evaluation and Management of  Acute Aortic Dissection: ACEP PolicyEvaluation and Management of  Acute Aortic Dissection: ACEP Policy
Evaluation and Management of Acute Aortic Dissection: ACEP Policy
 
C-Spine Collar Clearance In The Obtunded Adult Blunt Trauma Patient
C-Spine Collar Clearance In The Obtunded Adult Blunt Trauma PatientC-Spine Collar Clearance In The Obtunded Adult Blunt Trauma Patient
C-Spine Collar Clearance In The Obtunded Adult Blunt Trauma Patient
 
ASA Guidelines for Management of the Difficult Airway
ASA Guidelines for Management of the Difficult AirwayASA Guidelines for Management of the Difficult Airway
ASA Guidelines for Management of the Difficult Airway
 

Recently uploaded

Informed Consent Empowering Healthcare Decision-Making.pptx
Informed Consent Empowering Healthcare Decision-Making.pptxInformed Consent Empowering Healthcare Decision-Making.pptx
Informed Consent Empowering Healthcare Decision-Making.pptxSasikiranMarri
 
Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...
Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...
Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...Wessex Health Partners
 
Apiculture Chapter 1. Introduction 2.ppt
Apiculture Chapter 1. Introduction 2.pptApiculture Chapter 1. Introduction 2.ppt
Apiculture Chapter 1. Introduction 2.pptkedirjemalharun
 
Dwarka Sector 24 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few C...
Dwarka Sector 24 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few C...Dwarka Sector 24 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few C...
Dwarka Sector 24 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few C...rajnisinghkjn
 
epilepsy and status epilepticus for undergraduate.pptx
epilepsy and status epilepticus  for undergraduate.pptxepilepsy and status epilepticus  for undergraduate.pptx
epilepsy and status epilepticus for undergraduate.pptxMohamed Rizk Khodair
 
Measurement of Radiation and Dosimetric Procedure.pptx
Measurement of Radiation and Dosimetric Procedure.pptxMeasurement of Radiation and Dosimetric Procedure.pptx
Measurement of Radiation and Dosimetric Procedure.pptxDr. Dheeraj Kumar
 
Glomerular Filtration rate and its determinants.pptx
Glomerular Filtration rate and its determinants.pptxGlomerular Filtration rate and its determinants.pptx
Glomerular Filtration rate and its determinants.pptxDr.Nusrat Tariq
 
Glomerular Filtration and determinants of glomerular filtration .pptx
Glomerular Filtration and  determinants of glomerular filtration .pptxGlomerular Filtration and  determinants of glomerular filtration .pptx
Glomerular Filtration and determinants of glomerular filtration .pptxDr.Nusrat Tariq
 
Hematology and Immunology - Leukocytes Functions
Hematology and Immunology - Leukocytes FunctionsHematology and Immunology - Leukocytes Functions
Hematology and Immunology - Leukocytes FunctionsMedicoseAcademics
 
See the 2,456 pharmacies on the National E-Pharmacy Platform
See the 2,456 pharmacies on the National E-Pharmacy PlatformSee the 2,456 pharmacies on the National E-Pharmacy Platform
See the 2,456 pharmacies on the National E-Pharmacy PlatformKweku Zurek
 
Radiation Dosimetry Parameters and Isodose Curves.pptx
Radiation Dosimetry Parameters and Isodose Curves.pptxRadiation Dosimetry Parameters and Isodose Curves.pptx
Radiation Dosimetry Parameters and Isodose Curves.pptxDr. Dheeraj Kumar
 
call girls in dwarka DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in dwarka DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️call girls in dwarka DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in dwarka DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️saminamagar
 
POST NATAL EXERCISES AND ITS IMPACT.pptx
POST NATAL EXERCISES AND ITS IMPACT.pptxPOST NATAL EXERCISES AND ITS IMPACT.pptx
POST NATAL EXERCISES AND ITS IMPACT.pptxvirengeeta
 
97111 47426 Call Girls In Delhi MUNIRKAA
97111 47426 Call Girls In Delhi MUNIRKAA97111 47426 Call Girls In Delhi MUNIRKAA
97111 47426 Call Girls In Delhi MUNIRKAAjennyeacort
 
April 2024 ONCOLOGY CARTOON by DR KANHU CHARAN PATRO
April 2024 ONCOLOGY CARTOON by  DR KANHU CHARAN PATROApril 2024 ONCOLOGY CARTOON by  DR KANHU CHARAN PATRO
April 2024 ONCOLOGY CARTOON by DR KANHU CHARAN PATROKanhu Charan
 
call girls in GTB Nagar Metro DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...
call girls in GTB Nagar Metro  DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...call girls in GTB Nagar Metro  DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...
call girls in GTB Nagar Metro DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...saminamagar
 
LUNG TUMORS AND ITS CLASSIFICATIONS.pdf
LUNG TUMORS AND ITS  CLASSIFICATIONS.pdfLUNG TUMORS AND ITS  CLASSIFICATIONS.pdf
LUNG TUMORS AND ITS CLASSIFICATIONS.pdfDolisha Warbi
 
Statistical modeling in pharmaceutical research and development.
Statistical modeling in pharmaceutical research and development.Statistical modeling in pharmaceutical research and development.
Statistical modeling in pharmaceutical research and development.ANJALI
 
The New Standard of Care__Leveraging the Benefits of SGLT2 Inhibitors Across ...
The New Standard of Care__Leveraging the Benefits of SGLT2 Inhibitors Across ...The New Standard of Care__Leveraging the Benefits of SGLT2 Inhibitors Across ...
The New Standard of Care__Leveraging the Benefits of SGLT2 Inhibitors Across ...DrGoharMushtaq
 
QUALITY CONTROL OF SOLID DOSAGE FORMS (TABLETS , CAPSULES & POWDERS)
QUALITY CONTROL OF SOLID DOSAGE FORMS (TABLETS , CAPSULES & POWDERS)QUALITY CONTROL OF SOLID DOSAGE FORMS (TABLETS , CAPSULES & POWDERS)
QUALITY CONTROL OF SOLID DOSAGE FORMS (TABLETS , CAPSULES & POWDERS)Hasnat Tariq
 

Recently uploaded (20)

Informed Consent Empowering Healthcare Decision-Making.pptx
Informed Consent Empowering Healthcare Decision-Making.pptxInformed Consent Empowering Healthcare Decision-Making.pptx
Informed Consent Empowering Healthcare Decision-Making.pptx
 
Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...
Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...
Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...
 
Apiculture Chapter 1. Introduction 2.ppt
Apiculture Chapter 1. Introduction 2.pptApiculture Chapter 1. Introduction 2.ppt
Apiculture Chapter 1. Introduction 2.ppt
 
Dwarka Sector 24 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few C...
Dwarka Sector 24 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few C...Dwarka Sector 24 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few C...
Dwarka Sector 24 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few C...
 
epilepsy and status epilepticus for undergraduate.pptx
epilepsy and status epilepticus  for undergraduate.pptxepilepsy and status epilepticus  for undergraduate.pptx
epilepsy and status epilepticus for undergraduate.pptx
 
Measurement of Radiation and Dosimetric Procedure.pptx
Measurement of Radiation and Dosimetric Procedure.pptxMeasurement of Radiation and Dosimetric Procedure.pptx
Measurement of Radiation and Dosimetric Procedure.pptx
 
Glomerular Filtration rate and its determinants.pptx
Glomerular Filtration rate and its determinants.pptxGlomerular Filtration rate and its determinants.pptx
Glomerular Filtration rate and its determinants.pptx
 
Glomerular Filtration and determinants of glomerular filtration .pptx
Glomerular Filtration and  determinants of glomerular filtration .pptxGlomerular Filtration and  determinants of glomerular filtration .pptx
Glomerular Filtration and determinants of glomerular filtration .pptx
 
Hematology and Immunology - Leukocytes Functions
Hematology and Immunology - Leukocytes FunctionsHematology and Immunology - Leukocytes Functions
Hematology and Immunology - Leukocytes Functions
 
See the 2,456 pharmacies on the National E-Pharmacy Platform
See the 2,456 pharmacies on the National E-Pharmacy PlatformSee the 2,456 pharmacies on the National E-Pharmacy Platform
See the 2,456 pharmacies on the National E-Pharmacy Platform
 
Radiation Dosimetry Parameters and Isodose Curves.pptx
Radiation Dosimetry Parameters and Isodose Curves.pptxRadiation Dosimetry Parameters and Isodose Curves.pptx
Radiation Dosimetry Parameters and Isodose Curves.pptx
 
call girls in dwarka DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in dwarka DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️call girls in dwarka DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in dwarka DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
 
POST NATAL EXERCISES AND ITS IMPACT.pptx
POST NATAL EXERCISES AND ITS IMPACT.pptxPOST NATAL EXERCISES AND ITS IMPACT.pptx
POST NATAL EXERCISES AND ITS IMPACT.pptx
 
97111 47426 Call Girls In Delhi MUNIRKAA
97111 47426 Call Girls In Delhi MUNIRKAA97111 47426 Call Girls In Delhi MUNIRKAA
97111 47426 Call Girls In Delhi MUNIRKAA
 
April 2024 ONCOLOGY CARTOON by DR KANHU CHARAN PATRO
April 2024 ONCOLOGY CARTOON by  DR KANHU CHARAN PATROApril 2024 ONCOLOGY CARTOON by  DR KANHU CHARAN PATRO
April 2024 ONCOLOGY CARTOON by DR KANHU CHARAN PATRO
 
call girls in GTB Nagar Metro DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...
call girls in GTB Nagar Metro  DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...call girls in GTB Nagar Metro  DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...
call girls in GTB Nagar Metro DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...
 
LUNG TUMORS AND ITS CLASSIFICATIONS.pdf
LUNG TUMORS AND ITS  CLASSIFICATIONS.pdfLUNG TUMORS AND ITS  CLASSIFICATIONS.pdf
LUNG TUMORS AND ITS CLASSIFICATIONS.pdf
 
Statistical modeling in pharmaceutical research and development.
Statistical modeling in pharmaceutical research and development.Statistical modeling in pharmaceutical research and development.
Statistical modeling in pharmaceutical research and development.
 
The New Standard of Care__Leveraging the Benefits of SGLT2 Inhibitors Across ...
The New Standard of Care__Leveraging the Benefits of SGLT2 Inhibitors Across ...The New Standard of Care__Leveraging the Benefits of SGLT2 Inhibitors Across ...
The New Standard of Care__Leveraging the Benefits of SGLT2 Inhibitors Across ...
 
QUALITY CONTROL OF SOLID DOSAGE FORMS (TABLETS , CAPSULES & POWDERS)
QUALITY CONTROL OF SOLID DOSAGE FORMS (TABLETS , CAPSULES & POWDERS)QUALITY CONTROL OF SOLID DOSAGE FORMS (TABLETS , CAPSULES & POWDERS)
QUALITY CONTROL OF SOLID DOSAGE FORMS (TABLETS , CAPSULES & POWDERS)
 

ATLS 8e, The Evidence for Change

  • 1. Advanced Trauma Life Support ® , 8 th Edition, The Evidence for Change Volume 64(6). June 2008.1638-1650 http://decode-medicine.blogspot.com/ summarized by sun yaicheng
  • 2.
  • 3.
  • 4. A Brief Summary of Wright et al. Levels of Evidence. JBJS(A) Treatment Prognosis Diagnosis Economic and Decision analysis Level of Evidence 1 RCT with significant difference or narrow confidence intervals Prospective study with single inception cohort and 80% follow-up Testing of previously applied diagnostic criteria in a consecutive series against a gold standard Clinically sensible costs and alternatives; values obtained from many studies; multiway sensitivity analyses Systematic reviews of level 1 studies Systematic review of level 1 studies Systematic review of level 1 studies Systematic review of level 1 studies 2 Prospective cohort, poor quality RCT Retrospective study, untreated controls from a previous RCT Development of diagnostic criteria on basis of consecutive patients against a gold standard Clinically sensible costs and alternatives, values cobtained from limited studies, multiway sensitivity analyses Systematic reviews of level 2 studies Systematic review of level 2 studies Systematic review of level 2 studies Systematic review of level 2 studies 3 Case–control study Study of nonconsecutive patients (no consistently applied gold standard) Limited alternatives and costs; poor estimates Retrospective cohort study Systematic review of level 3 studies Systematic review of level 3 studies Systematic review of level 3 studies 4 Case series Case series Case–control study Poor reference standard No sensitivity analyses 5 Expert opinion Expert opinion Expert opinion Expert opinion
  • 6.
  • 8.
  • 9.
  • 10.
  • 11.
  • 12.
  • 13. Shock
  • 14.
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 22.
  • 23.
  • 24.
  • 25.
  • 27.
  • 28.
  • 30.
  • 31.
  • 32.
  • 33.
  • 34. Spine
  • 35.
  • 36.
  • 37.
  • 38.
  • 39. Power’s ratio to diagnose AOD shown on plain radiographs and CT scans of a patient without injury From: Dziurzynski: Spine, Volume 30(12). June 15, 2005.1427-1432
  • 40. Musculoskeletal trauma and extremity trauma
  • 41.
  • 42.
  • 44.
  • 45.
  • 47.
  • 48.
  • 49.
  • 50.