Trauma
Trauma Activation & Initial Assessment
Trauma activation criteria, trauma bay readiness, ABCDE primary survey, and damage control resuscitation framework. Based on ATLS principles and ACS TQIP guidance.
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Content Status
Guideline-supported example educational content* based on ATLS principles. Trauma activation criteria are institution-specific....Section
Content Status
Guideline-supported example educational content* based on ATLS principles. Trauma activation criteria are institution-specific....- Guideline-supported example educational content* based on ATLS principles. Trauma activation criteria are institution-specific. Always follow your institution's trauma activation protocol and attending guidance.
Trauma Activation Criteria (Common Examples)
GCS ≤ 13 or loss of consciousness • SBP < 90 mmHg • RR < 10 or > 29Section
Trauma Activation Criteria (Common Examples)
GCS ≤ 13 or loss of consciousness • SBP < 90 mmHg • RR < 10 or > 29Physiologic
- GCS ≤ 13 or loss of consciousness
- SBP < 90 mmHg
- RR < 10 or > 29
- Field intubation required
Anatomic
- Penetrating injury to head, neck, torso, or proximal extremities
- Open or depressed skull fracture
- Flail chest
- Suspected spinal cord injury with deficit
- Amputation proximal to wrist/ankle
- Two or more long bone fractures
Mechanism
- Ejection from vehicle
- Death of same-car occupant
- Vehicle intrusion > 12 inches on patient's side
- Pedestrian/bicyclist thrown or run over
- Fall > 20 feet
- High-risk auto vs. pedestrian (> 20 mph)
Primary Survey — ABCDE
Step • Focus • Key ActionsSection
Primary Survey — ABCDE
Step • Focus • Key Actions| Step | Focus | Key Actions |
|---|---|---|
| A | Airway (C-spine protection) | Jaw thrust, oral airway, intubate if needed |
| B | Breathing | Look/listen/feel; treat tension pneumothorax |
| C | Circulation + hemorrhage control | IV access, external bleeding control, assess shock |
| D | Disability | GCS, pupils, motor |
| E | Exposure / Environment | Full undress; prevent hypothermia |
Hemorrhage Control — Damage Control Resuscitation
Control external hemorrhage (pressure, tourniquet) • Resuscitate with blood products (1:1:1 — pRBC: FFP: Platelets) • Activate...Section
Hemorrhage Control — Damage Control Resuscitation
Control external hemorrhage (pressure, tourniquet) • Resuscitate with blood products (1:1:1 — pRBC: FFP: Platelets) • Activate...- Control external hemorrhage (pressure, tourniquet)
- Resuscitate with blood products (1:1:1 — pRBC: FFP: Platelets)
- Activate massive transfusion protocol (MTP) early
- Consider permissive hypotension (SBP 80–90) in penetrating trauma until hemorrhage controlled
- TXA within 3 hours of injury in appropriate patients
Adjuncts to Primary Survey
CXR, pelvis X-ray • FAST exam • Two large-bore peripheral IVsSection
Adjuncts to Primary Survey
CXR, pelvis X-ray • FAST exam • Two large-bore peripheral IVs- CXR, pelvis X-ray
- FAST exam
- Two large-bore peripheral IVs
- Labs: T&S, CBC, BMP, coags, lactate, ABG
- Foley catheter (if no urethral injury)
- 12-lead EKG if cardiac contusion suspected
- Guideline-supported example educational content based on ATLS principles and ACS TQIP guidance. Do not use without attending guidance and local institutional review.*