Atls (Advanced Trauma Life Support) Teaching Protocol

Pitfalls :

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  If the ventilation problem is produced by a pneumothrax, intubation with MV could lead to deterioration.
  
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  The procedure itself may produce a pneumothorax
  

Circulation with Hemorrhage Control

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  Q : What are the elements that provide the information about the hemodynamic status of the injured patients.
  

These elements are:

1. Level of consciousness

2. Skin color

3. Pulse ( quality, rate, regularity )

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  Presence of a carotid pulse  SBP 60 mmHg
  

femoral pulse  SBP 70 mmHg

radial puse  SBP 80 mmHg

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  External bleeding is identified and controlled in the primary survey.
  
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  Operative intervention for internal bleeding control.
  

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  Q : What are the injuries that may acutely impair circulation status ?
  

These injuries are :

1. External/internal bleeding with hypovolemic shock

2. Massive hemothorax

3. Cardiac tamponade

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  Assessment:
  

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  Identify source of external hemorrhage
  
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  Identify potential source(s) of internal hemorrhage /
  
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  Pulse / skin color, capillary refill / Blood pressure
  

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  Management:
  

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  Apply direct pressure to external bleeding site.
  
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  Internal hemorrhage ? Need for surgical intervention ?
  
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  Establish IV access / central line / IO
  
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  Fluid resuscitation / blood replacement
  

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  Important Notes :
  

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  Hypotension following injury must be considered to be hypovolemic in origin until proved otherwise.
  

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