The document outlines guidelines for treating patients with acute injuries. It recommends treating the most life-threatening problems first, prioritizing patients based on their chance of survival. The guidelines describe performing a primary survey following the ABCDE approach to assess airway, breathing, circulation, disability and exposure, then a secondary survey with a head-to-toe exam including vital signs, history, and physical examination. It also discusses triaging multiple casualties and transferring patients to trauma centers for definitive care.

1. Advanced Trauma Life Support For Doctors American College of Surgeons Committee on Trauma

3. Concept The most important of these premises was to treat the greatest threat to life first. The leak of a definitive diagnosis should never impede the application of an indicated treatment. A detailed history was not essential to begin the evaluation of an acutely injured patient

5. TRIAGE MULTIPLE CASUALTIES --- The number of patients and the severity of their injuries do not exceed the ability of the facility to render care. In this situation, patient with life-threatening problems and those sustaining mutiple-system injuries are treated first. Mass casualties --- The number of patients and the severity of their injuries exceed the capability of the facility and staff. In this situation, those patients with the greatest chance of survival and with the least expenditure of time, equipment, supplies, and personnel, are managed first.

7. Intervention should be followed in all injured patients A airway with cervical spine protection B breathing C circulation D disability or neurologic status E exposure(undress) and environment(temperature control)

11. Secondary survey Head-to-toe evaluation GCS Physical examine Lab examine History A allergies M medications currently used P past illness / pregnancy L last meal E event / environment related to injury

12. Transfer to trauma or burn center Definitive care

13. ISS Injury Severity Score Sum of square of the highest AIS in each of 3 most severity injury body regions ISS body regions---head & neck, face, Abd, chest, extremities, external

14. AIS Abbreviated injury scale 1. minor 2. moderate 3. serious 4. severe 5. critical 6. maximum injury virtually unsurvivable By definition any AIS body region score of 6 auto in an ISS of 75(fetal)