The cornerstone of trauma care is the

Advanced Trauma Life Support (ATLS)

approach, prioritising rapid assessment and resuscitation.

Trimodal Distribution of Trauma Deaths

• Immediate deaths: seconds to minutes after injury, typically from catastrophic brain, spinal cord, cardiac or great vessel injury. Salvage rate is extremely low.
• Early deaths: within hours, usually due to treatable causes such as splenic rupture, subdural haematoma, or haemothorax/pneumothorax.
• Late deaths: days to weeks later, secondary to sepsis or multi-organ failure.

Principles of Trauma Management

Primary Survey – ABCDE Approach

• A – Airway: with cervical spine protection.
• B – Breathing: assess chest expansion, oxygen saturation, tracheal position.
• C – Circulation: control catastrophic haemorrhage, assess perfusion, establish IV/IO access.
• D – Disability: brief neurological assessment (AVPU/GCS, pupils, glucose).
• E – Exposure: fully expose patient while preventing hypothermia.

Additional key points:

• Treat life-threatening conditions immediately when identified.
• Tension pneumothorax worsens with positive-pressure ventilation — decompress urgently.
• External haemorrhage: control using direct pressure, haemostatic dressings or tourniquets for life-threatening limb bleeding.
• Avoid blind clamping; use packing for inaccessible bleeding.
• Cervical spine: assume injury in all significant head/neck trauma until excluded.