Primary Survey in ATLS

Summary of the Primary Survey

  • Airway – Airway opened, airway obstruction treated, possible definitive airway placed
  • Breathing – Breathing assessed, tension pneumothorax and massive hemothorax treated, oxygen and assisted ventilation provided as needed
  • Circulation – Blood circulation and tissue perfusion assessed, intravascular volume loss replaced with fluids and blood, cardiac tamponade and cardiac arrest treated, emergency thoracotomy performed if needed, and external hemorrhage controlled
  • Disability – Neurologic status assessed
  • Exposure/environment – Patient fully undressed and environment controlled to protect from hypothermia or hyperthermia
  • Adjuncts – Trauma triple radiographs, laboratory studies, urinary or gastric catheters, temperature monitoring, consider blood transfusion

Trauma is the leading cause of death for people aged 1-44 years and is exceeded only by cancer and atherosclerotic disease in all age groups. Orthopedic surgery plays a key role in the treatment of the polytraumatized patient. The orthopedic surgeon is a member of a team consisting of many specialists, including emergency medicine physicians, trauma surgeons, neurosurgeons, and other surgical subspecialists. Each person on that team should be familiar with the basics of trauma resuscitations.

All resuscitations should be performed using Advanced Trauma Life Support (ATLS) guidelines.For the individual physician, assessment of the polytraumatized patient is performed using a stepwise approach, in which the airway is handled first and no procedures are initiated until the airway is secured. Then, breathing and circulation are addressed. In the trauma team approach, each team member should be assigned a specific task or tasks so that each of these can be performed simultaneously to ensure the most rapid treatment possible.


For more details on this topic which has been asked in DNB Theory examinations many a times , please click on the following link  :



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