ATLS concept

ATLS started in Nebraska, North America, after an orthopaedic surgeon crashed his plane, injuring his family. He found the delivery of emergency care to be inadequate. The aim of ATLS and resuscitation is to treat reversible, potentially life-threatening injuries, which become evident during the first 'golden' hour after trauma. ATLS provides a simple, structured system for the rapid assessment, treatment, re-evaluation, stabilization and possible transfer of the critically injured, enabling a physician to single-handedly and safely resuscitate a trauma victim, without specialist expertise.

ATLS emphasizes the need to treat trauma victims in a logical sequence, addressing resuscitation of life-threatening injuries in order of potential fatality, under the ABCDE mnemonic:

• Airway and cervical spine protection.

• Breathing and ventilation.

• Circulation and haemorrhage control.

• Disability and neurological status.

• Exposure and environment.

This forms the basis of the primary survey, interrupted only by regular reassessment and simultaneous treatment of injuries, followed by the secondary survey.

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