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Advanced Trauma Life Support

Article information

J Korean Med Assoc. 2007;50(8):680-691
Publication date (electronic) : 2007 August 31
doi : https://doi.org/10.5124/jkma.2007.50.8.680
Jae Myung Chung, MD
Department of Emergency Medicine, Kyungpook National University College of Medicine, Korea. jaechung@knu.ac.kr

Abstract

Among the deaths from trauma, 50% were dead at the scene, 30% in several hours, and 20% in a few weeks by multiple organ failure. The 30% occurring in several hours may be saved with rapid assessment and management of injuries. Trauma deaths could be reduced through an organized trauma system and standardized and systemic approach by physicians involved in the initial assessment and management of trauma. This is likely to present emergent and general traumatic care to increase the ability of treating trauma patients on the base of Advanced Trauma Life Support (ATLS) by the American College of Surgeons (ACS). Thus, both legal and systemic reform with an establishment of trauma centers or use of the ATLS program in intra-hospital trauma team is necessary to maximize operation of the medical team. Introduction of and emphasis on the skill oriented ATLS program in the medical school curriculum is also needed to prepare for real situations rather than knowledge-orientated education.

Keywords: Trauma; Triage; Primary survey; Resuscitation; Secondary survey

References

1. Cales RH, Trunkey DD. Preventable trauma deaths. A review of trauma care systems development. JAMA 1985. 2541059–1063.
2. Committee on Trauma, American College of Surgeons. Hospital and prehospital resources for optimal care of the injured patient. Bull Am Coll Surg 1983. 6811–21.
3. Mann NC, Mullins RJ, MacKenzie EJ, Jurkovich GJ, Mock CN. Systematic review of published evidence regarding trauma system effectiveness. J Trauma 1999. 47S25–S33.
4. Acosta JA, Yang JC, Winchell RJ, Simons RK, Fortlage DA, Hollingsworth-Fridlund P, Hoyt DB. Lethal injuries and time to death in a level I trauma center. J Am Coll Surg 1998. 186528–533.
5. Committee on Trauma, American College of Surgeons. Advanced trauma life support program for doctors 2004. 7th edth ed. Chicago: American College of Surgeons; 4–85.
6. Cornwell EE 3rd, Berne TV, Belzberg H, Asensio J, Velmahos G, Murray J, Demetriades D. Health care crisis from a trauma center perspective: The LA story. JAMA 1996. 276940–944.
7. Lucas CE. Resuscitation of the injured patient: the three phases of treatment. Surg Clin North Am 1977. 573–15.
8. Bickell WH, Wall MJ Jr, Pepe PE, Martin RR, Ginger VF, Allen MK, Mattox KL. Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Engl J Med 1994. 3311105–1109.
9. Brain Trauma Foundation. American Association of Neurological Surgeons. Congress of Neurological Surgeons. Joint Section on Neurotrauma and Critical Care. Indications for intracranial pressure monitoring. J Neurotrauma 2007. 24S37–S44.
10. Adelson PD, Bratton SL, Carney NA, Chesnut RM, du Coudray HE, Goldstein B, Kochanek PM, Miller HC, Partington MD, Selden NR, Warden CR, Wright DW. Guidelines for the acute medical management of severe traumatic brain injury in infants, children, and adolescents. Pediatr Crit Care Med 2003. 4S45–S48.
11. McKenney M, Lentz K, Nunez D, Sosa JL, Sleeman D, Axelrad A, Martin L, Kirton O, Oldham C. Can ultrasound replace diagnostic peritoneal lavage in the assessment of blunt trauma? J Trauma 1994. 37439–441.
12. Perez-Brayfield MR, Gatti JM, Smith EA, Broecker B, Massad C, Scherz H, Kirsch AJ. Blunt traumatic hematuria in children. Is a simplified algorithm justified? J Urol 2002. 1672543–2546.
13. Morey AF, Bruce JE, McAninch JW. Efficacy of radiographic imaging in pediatric blunt renal trauma. J Urol 1996. 1562014–2018.

Article information Continued

Copyright © 2007 Korean Medical Association

Table 1

Indications for Definitive Airway

Table 1

(Source: Committee on Trauma, American College of Surgeons. Advanced trauma life support program for doctors. 7th ed. Chicago: American College of Surgeons, 2004: 46.)

Table 2

Estimated fluid and blood losses* based on patient's initial presentation

Table 2

(Source: Committee on Trauma, American College of Surgeons. Advanced trauma life support program for doctors. 7th ed. Chicago: American College of Surgeons, 2004: 74.)

*: for a 70-kg man

Table 3

Responses to Initial Fluid Resuscitation*

Table 3

(Source: Committee on Trauma, American College of Surgeons. Advanced trauma life support program for doctors. 7th ed. Chicago: American College of Surgeons, 2004: 79.)

*Adult; 2L Ringer's lactate solution, Children; 20mL/kg Ringer's lactate solution

Table 4

Glasgow Coma Scale

Table 4

Table 5

Mechanism of Injury and Related Suspected Injury Patterns

Table 5

(Source: Committee on Trauma, American College of Surgeons. Advanced trauma life support program for doctors. 7th ed. Chicago:American College of Surgeons, 2004: 22.)

Table 6

Secondary Survey

Table 6

(Source: Committee on Trauma, American College of Surgeons. Advanced trauma life support program for doctors. 7th ed. Chicago: American College of Surgeons, 2004: 39-40.)