As clinicians , we have to face trauma patients on day to day basis. But no discussion on trauma can end without knowing about ATLS. The Advanced Trauma Life Support (ATLS) system prioritizes patient care based on the urgency of the threat to life (the “time dependence principle”), postponing detailed histories for rapid problem identification and treatment. It includes primary , secondary and tertiary survey.
1. Primary Survey (Immediate Stabilization)
Exsanguinating External Hemorrhage: Controlled immediately with packs and pressure before addressing the airway.
Airway: Assessed immediately while maintaining cervical spine immobilization.
Breathing: High-flow oxygen is administered; life-threatening chest pathologies are treated immediately.
Circulation: Requires at least two large-bore IVs for fluid resuscitation while identifying hemorrhage sources; hypotension is treated as hypovolemia.
Disability: Rapid neurological check via GCS score, pupil response, and limb movement.
Environment/Exposure: The patient is exposed for examination but kept warm with blankets and warmed fluids to prevent hypothermia and worsened coagulopathy.
2. Secondary & Tertiary Surveys
Secondary Survey: A detailed, head-to-toe examination performed only after the patient is stabilized and life-threatening injuries are managed.
Tertiary Survey: Conducted once the patient is alert and extubated to catch missed, “minor” injuries (e.g., fractures or tears) that could cause long-term disability.
Have you applied the principles of ATLS in your practice in handling trauma patients?
MBH/DB