Advanced Trauma Life Support ATLS Student Course Manual 2018

Appendix C
TRAUMA CARE IN MASS-CASUALTY, AUSTERE,
AND OPERATIONAL ENVIRONMENTS
(OPTIONAL LECTURE)
OBJECTIVES
1. Describe how mass-casualty events create a
population-based standard of care.
2. Describe tools for effective mass-casualty care.
3. List the priorities for care of an individual in
mass-casualty situations.
4. Discuss challenges for mass-casualty care.
6. Review the principles of Tactical Combat Casualty
Care (TCCC).
7. Outline the concept of the Advanced Trauma Life
Support® in the Operational Environment (ATLS-OE)
supplemental curriculum.
8. Define the principles for management of intentional
mass-casualty and active shooter events.
5. Identify challenges of providing trauma care in operational,
austere, and resource-constrained environments.
The ability to provide quality trauma care in any
resource-constrained environment, including
areas of conflict, disaster, and other austere
settings, may be highly variable. In the worst-case
scenario, adequate care may be available only through
delivery of external resources to the battlespace or
site of disaster. The many challenges associated with
functioning within the disaster or austere environment
will affect every echelon or level of care, from the point
of injury to the evacuation of the casualty to a modern
tertiary care center (when possible). All healthcare
providers in these environments must understand these
limitations and how they will critically impact trauma
care, as well as of the strategies available to mitigate
these disadvantages. Enhanced situational awareness
is of paramount importance in these settings.
Disasters occur globally due to natural and
technological phenomena as well as human conflict.
No community is immune. Even the most sophisticated
hospitals can become austere facilities after a
disaster, due to limitation of available resources and/
or overwhelming numbers of casualties. Effective
disaster management is not business as usual; it
requires a unique mind-set that recognizes the need
for a population-based standard of care and healthcare
worker safety. “Adapt and overcome” is the slogan
for readiness.
Advanced Trauma Life Support (ATLS) had its origins
in a Nebraska cornfield following a plane crash in which
the injured received inadequate care in an austere
environment. Although commonly seen through the
lens of plentiful resources, ATLS provides an initial
framework for all trauma patients and is applicable
in mass-casualty events and austere or conflict-ridden
environments with limited resources. Further depth can
be found in the American College of Surgeons Disaster
Management and Emergency Preparedness (DMEP)
course and the U.S. Military’s Advanced Trauma Life
Support® for the Operational Environment (ATLS-OE).
Mass-cAsualty Care
A mass-casualty event exists when casualties exceed
the resources to provide complete individual care,
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