ATLS 5 Steps 1 2 3 Preparation Triage

ATLS: 5 Steps 1. 2. 3. Preparation Triage Primary survey (ABCDE) + Resuscitation n 4. Secondary survey n n 5. Adjuncts to primary survey Adjuncts to secondary survey Continued monitoring and reevaluation Definite care / Transfer

Primary Survey n n n 考題！ Airway + C-spine protection Breathing + R/O tension pneumothorax Circulation + stop bleeding Disability (GCS) + pupils + MP x 4 Exposure + Environmental control

Adjuncts to Primary Survey n n NG/OG, Foley X-rays: Chest, pelvis, c-spine DPL or FAST Monitoring: ECG, BP, Sp. O 2, ABG, ETCO 2

Secondary Survey Does not begin until n Primary survey (ABCDE) is completed n Normalization of vital signs after resuscitation

Secondary Survey n Complete History n n AMPLE Complete PE Head to toes n Finger to holes n

Secondary Survey n History: n Allergies n Medication n Past illness / pregnancy n Last meal n Events / environment

Adjuncts to Secondary Survey Specialized diagnostic tests n CT scans n Contrast x-rays n Extremity x-rays n Endoscopy and ultrasonography

Reevaluation n Reevaluation constantly (start with ABCDE) To discover new findings n To discover deterioration n n Continuous monitoring Vital signs, EKG n U/O n ABG, Sp. O 2 n ETCO 2 n

Definite Care and Transfer n n n Decision during the primary survey and resuscitation D 2 D communication Transfer after life-saving resuscitation