Advanced Trauma Life Support For Doctors

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Advanced Trauma Life Support For Doctors

• American College of Surgeons Committee on Trauma

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Concept

• The most important of these premises was to treat
  the greatest threat to life first.
• The leak of a definitive diagnosis should never
  impede the application of an indicated treatment.
• A detailed history was not essential to begin the
  evaluation of an acutely injured patient

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TRIAGE

• MULTIPLE CASUALTIES --- The number of patients
  and the severity of their injuries do not exceed
  the ability of the facility to render care. In
  this situation, patient with life-threatening
  problems and those sustaining mutiple-system
  injuries are treated first.
• Mass casualties --- The number of patients and
  the severity of their injuries exceed the
  capability of the facility and staff. In this
  situation, those patients with the greatest
  chance of survival and with the least expenditure
  of time, equipment, supplies, and personnel, are
  managed first.

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Intervention should be followed in all injured
patients

• A airway with cervical spine protection
• B breathing
• C circulation
• D disability or neurologic status
• E exposure(undress) and
• environment(temperature control)

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Secondary survey

• Head-to-toe evaluation
• GCS
• Physical examine
• Lab examine
• History A allergies
• M medications currently used
• P past illness / pregnancy
• L last meal
• E event / environment related to
  injury

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• Transfer to trauma or burn center
• Definitive care

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ISSInjury Severity Score

• Sum of square of the highest AIS in each of 3
  most severity injury body regions
• ISS body regions---head neck, face, Abd,
• chest, extremities, external

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AISAbbreviated injury scale

• 1. minor
• 2. moderate
• 3. serious
• 4. severe
• 5. critical
• 6. maximum injury virtually unsurvivable
• By definition any AIS body region score of 6 auto
  in an ISS of 75(fetal)