GENERAL PRINCIPLE OF TRAUMA ( ATLS )

Advanced Trauma Life Support ( ATLS ) is the standard of care for trauma
patients. This protocol ensures that the most immediate life-threatening
conditions are quickly identified and addresses in the order of their risk potential.
A. PRIMARY SURVEY ( ABCDE )
The first and key part of the assessment of patients presenting with
trauma is called primary survey. During this time, life-threatening
injuries are identified and simultaneously resuscitation is begun.
1. Airway

: Assess the ability of air to pass. Can be opened by

chin lift or jaw thrust. If the airway is blocked, the fluid must be cleaned
out by using suctioning instrument.
2. Breathing
: Determine the ability to ventilate and oxygenate.
Examined by inspection, palpation, percussion, and auscultation.
3. Circulation
: Evaluate the circulation by identifying
hypovolemia, cardiac tamponade, and external sources of hemorrhage.
4. Disability
: Performing gross mental status and motor
examination. Determine whether a serious head or spinal cord injury
exist.
5. Exposure and Enviromental control : Patient should be completely
undresses for a thorough physical examination, usually by cutting off
the garments. Patient privacy should be maintined.
B. RESUSCITATION
C. SECONDARY SURVEY
Formally begin after completing primary survey and after starting
resuscitation phase. At this time, identify all injuries by conducting
thorough head-to-toe examination. Review patients vital sign and review
patients history.
D. Definitive Care
Either definitive treatment or transfer to an appropriate trauma center for
definitive care.
BHP, PHOP, CRP
A. BHP

1. The patients have right to get the treatment immediately ( ATLS )

before getting further management.
2. Informed consent before doing ORIF
3. Legal term related to investigation by police department : investigator (
police ) has authority to request examination and explanation
regarding wound, intoxification, or death of a victim to a doctor.
B. PHOP
1. Giving advice to avoid the fight.
2. Doing ORIF as a curative way.
3. Hospitalized after doing ORIF 1 7 days.
C. CRP
1. Rata-rata rawat inap untuk trauma kepala sebanyak 146,3 per 100.000
dan 158,3 per 100.000 ( Thomas, 2006 ).
2. Angka kematian trauma kepala lebih tinggi pada laki-laki yaitu
sebanyak 26,9 per 100.000.