Atls (Advanced Trauma Life Support) Teaching Protocol

Pitfalls :

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  The elderly, children, athletes and others with chronic medical conditions do not respond to volume loss in similar manner
  

Disability

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  Assessment :
  

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  Level of consciousness in the AVPU scale
  

Alert

Voice illicits response

Pain illicits response

Unresponsive

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  GCS
  

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  Pupils size, equality and reaction
  

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  Management :
  

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  Intubation and allow mild hyperventilation
  
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  Administer IV mannitol ( 1.5-2.0g/kg )
  
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  Arrange for brain CT
  

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  Important notes :
  

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  CT is contraindicated when the patient is hemodynamically unstable
  
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  A decrease in the level of consciousness may due to:
  

1. 
   Decreased cerebral oxygenation (A,B)
   
2. 
   Decreased cerebral perfusion (C)
   
3. 
   Direct cerebral injury (D)
   
4. 
   Alcohol / drugs
   

Always rule out hypoxemia and hypovolemia first.

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  Reevaluation
  

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