Advanced Trauma Life Support ATLS Student Course Manual 2018

285
APPENDIX C n Trauma Care in Mass-Casualty, Austere, and Operational Environments
enough; the lay bystander must be empowered to act
in time of emergency (n FIGURE C-2).
Bleeding Control for the Injured
Bleeding Control for the Injured (B-Con), a short
modular course developed by the National Association
of Emergency Medical Technicians and co-sponsored
by the American College of Surgeons Committee on
Trauma in support of the national “Stop the Bleed”
campaign. It is designed to instruct either the layperson
immediate responder with no medical training or the
professional responder, adapted from TCCC/PHTLS
principles, this course introduces the concepts of
external pressure, tourniquets, hemostatic dressings,
and basic airway maneuvers. An additional module
for professional responders includes an introduction
to THREAT principles. For more information on the
B-Con course, visit www.bleedingcontrol.org or contact
your ATLS state chair or international region chief.
SummARy
1. Mass-casualty incidents change the fundamental
treatment paradigm from maximizing the outcomes
for an individual to maximizing outcomes for the
largest number of people.
2. Tools for improving mass-casualty care include
establishment and communication of triage categories
and use of the Incident Command System.
3. Challenges after a mass-casualty incident are
both immediate (overwhelming numbers and
types of patients, security, supplies, communication,
transportation), and long term (fatigue,
dehydration, psychological).
4. The principles of ATLS provide a framework for
evaluating and treating life-threatening injuries
in all situations and environments; however, these
principles must be adapted to the situation based
on available resources.
5. Austere and operational environments require
increased situational awareness and detailed
prearrival and pretransfer assessments due to
resource constraints.
6. The Stop the Bleed Campaign provides for
hemorrhage control training for the public and
empowers the immediate bystander to act.
Additional Resources
Incident Command System
https://www.fema.gov/incident-commandsystem-resources
Blast injuries
https://emergency.cdc.gov/masscasualties/
blastinjury-mobile-app.asp
Chemical and Radiation Hazards
https://www.remm.nlm.gov/
https://chemm.nlm.nih.gov/
Stop the Bleed/Hartford consensus/Bleeding Control
for the Injured course
https://www.facs.org/about-acs/hartfordconsensus
https://bleedingcontrol.org
ATLS for the Operational Environment
For more information about ATLS-OE, the
Region XIII (Military) Chief may be contacted via
the ATLS Program Office.
Bibliography
1. Auf der Heide E. Disaster Response: Principles of
Preparation and Coordination. St. Louis, MO: C.V.
Mosby Company; July 1989.
2. Beninati W, Meyer MT, Carter TE. The critical care
air transport program. Crit Care Med 2008;36(7
Suppl):S370–376.
3. Blair JP, Schweit KW. A Study of Active
Shooter Incidents, 2000–2013. Texas State
University and Federal Bureau of Investigation.
Washington, DC: U.S. Department of
Justice; 2014.
4. Bulger E, Snyder D, Schoelles K, et al. An
evidence-based prehospital guideline for
external hemorrhage control. American
College of Surgeons Committee on
Trauma. Prehosp Emerg Care 2014;18(2):
163–173.
5. Butler FK, Blackbourne LH. Battlefield trauma
care then and now: a decade of Tactical Combat
Casualty Care. J Trauma 2012;73(6 Suppl
5):S395–S402.
6. Butler FK, Giebner SD, McSwain N, et al., eds.
Prehospital Trauma Life Support Manual. 8th ed.,
military version. Burlington, MA: Jones and
Bartlett Learning; 2014.
n BACK TO TABLE OF CONTENTS