Trauma management: an overview

Question 1

What is ATLS?

Answer 1

Advanced Trauma Life Support

Question 2

What are the principles of trauma management?

Answer 2

'ABCDE'
Airway
Breathing
Circulation
Disability - pupils, AVPU (alert, voice, pain, unresponsive)
Exposure - bleeding, rash
Cervical spine

Question 3

How to check airway?

Answer 3

look, listen, feel, suction if blood or vomit
Head tilt, chin lift, jaw thust
In hospital : awake intubation, fibre optic intubation, cricothyroidotomy, chest drain so lungs dont collapse

Question 4

How to assess breathing?

Answer 4

look, listen, feel - rate, gurgling, wheeze, give oxygen
‘ATOMFC’
Airway obstruction - intubation
Tension pneumothorax - when breathe in, wall expands and lungs move up and air comes in. When are is trapped between lung and chest, you cant breathe it out and more air comes into this space when breather in - get tracheal deviation
Open pneumothorax
Massive pneumothorax - same as tension but blood not air
Flail chest - broken ribcage, collapses and lung cant expand
Cardiac tamponade - blood between heart and pericardium

Question 5

How to asses circulation?

Answer 5

pulse, colour of skin, temp of peripherals, capillary refill, BP
Following trauma, blood will go to the abdomen, pelvis, femur, chest cavity
Managing acute blood loss - volume replace and stop flow out

Question 6

How to assess disability?

Answer 6

pupil reflex, AVPU, blood sugar levels
Brain damage leading cause of disability in young males
presents as altered behaviors, poor attention span, reduced concentration, headache

Question 7

What to do for acute management?

Answer 7

Oxygen, pupillary responsiveness, posture, glucose

Good management reduces long term problems