The document discusses trauma management and activation of a trauma team. It outlines the Advanced Trauma Life Support (ATLS) protocol which involves a primary survey to identify life-threatening injuries, followed by a secondary survey and development of a treatment plan. The primary survey focuses on the ABCDEs - Airway, Breathing, Circulation, Disability, and Exposure/Environment. It provides details on assessing each component and treating critical issues like tension pneumothorax, massive bleeding, and neurological impairment.

1. Trauma Management
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2. Activation of a Trauma Team
 Doctors from different specialties, nurses and
radiographers.
 Team leader: Takes all Triage decisions and
coordinates the entire resuscitative effort.
 Hospital is informed about the impending arrival of a
casualty.

3. Prehospital Retrieval and Management
Approach:
Scoop & Run policy
Stay & Play policy
Universal precautions

4. Advanced Trauma Life Support (ATLS)
Primary survey and Resuscitation: Identify
and treat what is killing the patient.
Secondary survey: Proceed to identify other
injuries.
Definitive care: Develop a definitive
management plan.

5. ATLS- Primary Survey
A – Airway maintenance & Cervical Spine protection.
B – Breathing & ventilation.
C – Circulation & hemorrhage control
D – Disability limitation
E – Exposure & environment.

6. ATLS- PRIMARY SURVEY
A-AIRWAY
 If pt. can speak- not immediately threatened.
 If not, rapid assessment needed.
Inspection:
 foreign bodies, maxillofacial or tracheal /laryngeal
fractures
 Cervical spine injury in multisystem injury, injury above
the clavicle.

7. ATLS- Primary Survey
B- Breathing & ventilation
• High flow oxygen using reservoir mask
• Inspection
• Palpation
• Movement
• Auscultation
The aim is to identify & treat the life threatening
thoracic conditions.

8. ATLS- Primary Survey
B- Breathing & ventilation
Five life threatening thoracic conditions:
1. Tension Pneumothorax
2. Massive Hemoperitoneum
3. Open chest injuries
4. Cardiac tamponade

9. ATLS- Primary Survey
C- Circulation and bleeding control
Tachycardia in a cold patient indicates shock
Causes of shock following injury:
1. Hypovolemic
2. Cardiogenic
3. Neurogenic
4. Septic

10. ATLS- Primary Survey
C- Circulation and bleeding control
 Assessment of blood loss
-External or obvious
-Internal or covert: chest
abdomen
retroperitoneum
muscle compartments
 Resuscitation
Arrest bleeding
Obtain vascular access

11. ATLS- Primary Survey
C- Circulation and bleeding control
 External bleeding must be controlled.
 IV access
 Blood for cross-match.
 Bolus of warm crystalloid.
 Timely surgical intervention to arrest haemorrhage.

12. ATLS- Primary Survey
D- Disability limitation
C.N.S.
• Rapid assessment of motor & sensory functions
• Glassgow coma scale
• Pupillary assessment by prehospital personnel
ATLS-Primary survey
E- Exposure and environment
• Remove remaining clothing.
• Prevent hypothermia.

13. Adjunct to primary survey
• Monitoring-
ECG, non-invasive BP, pulse oximetry
• Urinary and gastric catheters
• Diagnostic studies: lateral cervical spine
AP chest
AP pelvis
• Focus Abdominal Sonar for Trauma (FAST) scan
• CT scan or diagnostic peritoneal lavage