ATLS ABCDE Systematic Life-Support Pipeline
Inline C-Spine stabilization. Assess patency, suction, rapid sequence intubation (RSI).
Inspect chest rise, bilateral breath sounds, immediate needle decompression (5th ICS AAL).
Direct pressure, tourniquets, MTP 1:1:1 blood transfusion, pelvic binder, TXA within 3h.
Glasgow Coma Scale (GCS 3-15), pupillary light reflex, lateralizing motor signs.
Complete log roll to inspect back, warm blankets & fluid warmers to prevent hypothermia.
Airway with Cervical Spine Protection
Assume cervical spine injury in all blunt trauma patients. Maintain manual inline stabilization while establishing a definitive airway. "GCS of 8, time to intubate!"
The 4 Classes of Shock & Lethal Triad
• Blood Loss: <15% (<750 mL)
• HR: <100 BPM
• BP: Normal
• Mental: Slightly anxious
• Blood Loss: 15-30% (750-1500 mL)
• HR: >100 BPM
• BP: Normal/Narrow Pulse
• Mental: Mildly anxious
• Blood Loss: 30-40% (1500-2000 mL)
• HR: >120 BPM
• BP: Hypotensive (<90 SBP)
• Mental: Confused / Oliguric
• Blood Loss: >40% (>2000 mL)
• HR: >140 BPM
• BP: Profound Hypotension
• Mental: Lethargic / Arrest
⚠️ The Lethal Triad of Trauma Mortality >90%
ACLS Code Blue & 200J Biphasic Defibrillator
Hypovolemia, Hypoxia, Hydrogen ion (Acidosis), Hypo/Hyperkalemia, Hypothermia.
Tension pneumothorax, Tamponade (cardiac), Toxins, Thrombosis (pulmonary), Thrombosis (coronary).
FAST & eFAST 4-Window Ultrasound Matrix
1. Right Upper Quadrant (Morrison's Pouch)
💧Hepatorenal recess. Most dependent abdominal space in supine trauma; first site of hemoperitoneum collection.
2. Left Upper Quadrant (Splenorenal)
🛡️Inspects subdiaphragmatic space and splenorenal recess for fluid from splenic parenchymal lacerations.
3. Subxiphoid (Cardiac Pericardial)
❤️Inspects pericardial sac for anechoic fluid stripe (hemopericardium) in Beck's Triad cardiac tamponade.
4. Suprapubic (Pouch of Douglas)
🩻Evaluates retrovesical / rectouterine space behind the bladder for free fluid prior to urinary catheterization.