ATLS Primary Survey

Primary Survey

1. Airway Maintenance with Cervical Spine Protection

• "Airway Obstruction"
• Airway Manipulation
• check for FB and related fractures
• repeated assessment
• cervical spine immobilization-manual in line stabilization (MILS)

  
Comparison of cervical spine stabilization

2. Breathing and ventilation

• "Tension Pneumothorax"
  "Massive Hemothorax"
  "Open Pneumothorax"
  "Fail Chest with Pulmonary Contusion"
• Needle decompression, tube thoracostomy

3. Circulation with hemorrhage control

• Cardiac Tamponade
• blood volume and cardiac output-level of consciousness, skin color, pulse
• bleeding- SCALPeR
• Two large-caliber IV catheters, rate of infusion related to the internal diameter of the catheter and inversely by its length (not by the size of the vein)

  "Are 2 smaller intravenous catheters as good as 1 larger intravenous catheter?"

• IV solutions warmed or storage in 37~40 degree Celcius; high-flow fluid warmer for crystalloid fluids to 39 degree Celcius but blood product should not be warmed in a microwave oven.

4. Disability (Neurologic evaluation)

• Level of consciousness
• pupillary size and reaction
• lateralizing signs
• spinal cord injury level
• cerebral oxygenation/perfusion VS direct cerebral injury

5. Exposure/environment control