ICU · Resuscitation
Trauma resuscitation and primary survey (ATLS)
Also known as ATLS primary survey · ABCDE approach to trauma · Damage control resuscitation (DCR) · Traumatic cardiac arrest
Trauma resuscitation in the ICU and resuscitation bay: ATLS 10, tension pneumothorax and traumatic cardiac arrest (HOTT), acute traumatic coagulopathy, permissive hypotension, tranexamic acid (CRASH-2, MATTERs, PATCH-Trauma), balanced transfusion (PROPPR, PAMPer), European guideline targets, pelvic haemorrhage, damage control surgery, TBI (hypotension, RSI, CPP, RESCUEicp, CRASH-3), blunt aortic injury, crush and rhabdomyolysis, abdominal compartment syndrome and fat embolism.
Checked against its sources on 8 Oct 2026
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Target exams
Red flags
- Catastrophic external haemorrhage: control with direct pressure/tourniquet BEFORE airway management
- Tension pneumothorax: needle decompression (2nd ICS midclavicular or 5th ICS midaxillary) — do NOT wait for CXR
- Permissive hypotension is CONTRAINDICATED in traumatic brain injury (need MAP >80 for CPP)
- Traumatic cardiac arrest: focus on reversible causes (4 Hs and 4 Ts), not standard CPR algorithm
The structured approach
ATLS 10th edition recommends a highly structured approach to the injured patient and endorses several advances: less stringent crystalloid guidance, video-assisted laryngoscopy, viscoelastic methods to guide transfusion, a trauma-team approach, more focus on special populations, and restriction of spinal motion rather than routine spinal immobilisation.[1]
References37ShowHide
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