Advanced Trauma Life Support ATLS Student Course Manual 2018

Pitfall
Inadequate
security
Failed
communication
Over-triage
prevention
• Include security provisions in
disaster plans.
• Be prepared to reroute/limit flow
into the hospital.
• Be mindful of surroundings
(situational awareness).
• Don’t assume landlines and cell
phones will function.
• Have backup such as runners and
walkie-talkie radios available for
use.
• Take available resources into
account.
• Use minimally acceptable care
(crisis management care).
MCE response in their training, given the complexity
of today’s disasters.
The goal of the disaster medical response, both prehospital
and hospital, is to reduce the critical mortality
associated with a disaster. Critical mortality rate is
defined as the percentage of critically injured survivors
who subsequently die. Numerous factors influence the
critical mortality rate, including:
••
Triage accuracy, particularly the incidence of
over-triage of victims
••
Rapid movement of patients to definitive care
••
Implementation of damage control procedures
••
Coordinated regional and local disaster
preparedness.
Bibliography
Under-triage
Inadequate
capacity to
manage influx
of patients
errors, and surge capabilities. The lessons learned from
previous disasters are invaluable in teaching us how
to better prepare for them.
SummARy
• Use personnel trained in rapid
triage to perform this task.
• Apply the ABCDs within the
framework of doing the greatest
good for the greatest number of
patients.
• Remember that capacity does not
equal capabilities.
• Make provisions for the obtaining
the personnel and equipment
necessary to align capability and
capacity.
A consistent approach to disasters by all organizations,
including hospitals, based on an understanding of their
common features and the response they require, is
becoming the accepted practice throughout the world.
The primary objective in a mass casualty event is to
reduce the mortality and morbidity caused by the
disaster. The ATLS course is an important asset in
accomplishing these goals.
ATLS guidelines for managing traumatic injuries
are applicable to all disaster situations. All medical
providers need to incorporate the key principles of the
1. Ahmed H, Ahmed M, et al. Syrian revolution:
a field hospital under attack. Am J Disaster Med
2013;8(4); 259–265.
2. American Academy of Pediatrics (Foltin GL,
Schonfeld DJ, Shannon MW, eds.). Pediatric
Terrorism and Disaster Preparedness: A Resource
for Pediatricians. AHRQ Publication No. 06-
0056-EF. Rockville, MD: Agency for Healthcare
Research and Quality; 2006. http://www.ahrq.
org/research/pedprep/resource.htm. Accessed
February 26, 2008.
3. Bartal C, Zeller L, Miskin I, et al. Crush syndrome:
saving more lives in disasters, lessons learned
from the early-response phase in Haiti. Arch
Intern Med 2011;171(7):694–696.
4. Born C, Briggs SM, Ciraulo DL, et al. Disasters and
mass casualties: II. Explosive, biologic, chemical,
and nuclear agents. J Am Acad of Orthop Surg
2007;15:8:461–473.
5. Briggs, SM. Advanced Disaster Medical Response,
Manual for Providers. 2nd ed. Woodbury, CT: Cine-
Med; 2014.
6. Committee on Trauma, American College of
Surgeons. Disaster Management and Emergency
Preparedness Course. Chicago, IL: American
College of Surgeons; 2009.
7. Gutierrez de Ceballos JP, Turegano-Fuentes
F, Perez-Diaz D, et al. 11 March 2004: the
terrorist bomb explosions in Madrid, Spain—
an analysis of the logistics, injuries sustained
and clinical management of casualties treated
at the closest hospital. Crit Care 2005;9:
104–111.
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