Trauma

ATLS: Primary Survey Overview

1. Airway
   • Assess patency
   • Assess any airway trauma
   • Intervene as needed to secure/protect airway
2. Breathing
   • Assess presence/adequacy of respirations
   • Pulse oximetry
   • Intervene as needed
3. Circulation
   • Stop obvious bleeding
   • 2 large bore IVs
     • 16 Ga minimum
   • Central access if necessary
   • FAST/RUSH exam
4. Disability
   • Neurologic status
     • Glasgow coma scale (Open Calc)
   • Status
     • Revised trauma score (Open Calc)
       • Consider also Trauma score (Open Calc)
5. Exposure/Environment
   • Remove all clothing and jewelry
   • Cover patient after initial exam

References

1. Rotondo MF, Fildes J, Brasel KJ, et al. Advanced Trauma Life Support Student Manual 9th Edition. American College of Surgeons, 9th ed., 2012;pp.2-21
2. Marx JA, Hockberger RS, Walls RM, et al. Rosen's Emergency Medicine Concepts and Clinical Practice, 8th Ed., Philadelphia, PA: Elsevier-Saunders, 2014;pp.287-295
3. Gin-Shaw SL, Jorden RC. Multiple Trauma. In: Marx: Rosen's Emergency Medicine: Concepts and Clinical Practice, 5th ed., Philadelphia, PA: Elsevier-Saunders, 2002;pp.242-255
4. Hoyt DB, Coimbra R, Potenza B. Management of Acute Trauma. In: Townsend: Sabiston Textbook of Surgery, 17th ed., 2004;pp.483-529

Contributor(s)

1. Thota, Darshan, MD, FAWM

Updated/Reviewed: January 2021