Scribd
Upload
9K views2 pages

ATLS 11 Updates

The ATLS 11th Edition update introduces a new priority for rapid hemorrhage control, emphasizing the use of tourniquets and hemostatic agents in massive bleeding cases. It advocates for a context-based approach to airway management, highlighting modified RSI techniques and the use of video laryngoscopy. Additionally, it addresses special populations such as geriatric patients and trauma in pregnancy, focusing on frailty and multidisciplinary planning.

Uploaded by

Vaishnavi Agrawal
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Related knowledge pages

9K views2 pages

ATLS 11 Updates

The ATLS 11th Edition update introduces a new priority for rapid hemorrhage control, emphasizing the use of tourniquets and hemostatic agents in massive bleeding cases. It advocates for a context-based approach to airway management, highlighting modified RSI techniques and the use of video laryngoscopy. Additionally, it addresses special populations such as geriatric patients and trauma in pregnancy, focusing on frailty and multidisciplinary planning.

Uploaded by

Vaishnavi Agrawal
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Related knowledge pages

ATLS 11th Edition UPDATE

X
• New Priority: Rapid hemorrhage control takes precedence over airway in patients with massive
bleeding, redefining the classic ABCDE to xABCDE.
• Tourniquets and Hemostatic Agents: Emphasis on early use of tourniquets and hemostatic
dressings in hospital setting.
• Emphasis on the application of tourniquet for extremity wounds with rapid bleeding from large
vessels or with multiple sites of bleeding (e.g., “mangled” extremities).

A
• Context-Based Approach: Encourages individualized airway decisions—not all trauma
patients benefit from immediate intubation. Drug-assisted intubation in patients with
circulatory compromise must consider hemodynamics first.
• Modified RSI is the preferred intubation technique, with:
o Preoxygenation and apneic oxygenation via nasal cannula
o Avoidance of over-sedation and hypotension through careful drug selection and dose
adjustment (Drug-facilitated intubation).
o Etomidate and ketamine preferred for their cardiovascular stability
o Use of vasopressors preemptively if patient is hypotensive
• If oxygenation and ventilation are adequate, the manual advises delaying definitive intubation
until conditions are optimal (e.g., personnel, equipment, hemodynamic stabilization).
• Video Laryngoscopy: Promoted as a preferred technique in complex airways when available.

B
• Thoracostomy Decisions: Removed strict volume criteria. Surgical decisions now prioritize
clinical and physiologic assessment.
• Smaller-Gauge Needles for Needle Thoracotomy: Highlighted for needle decompression in
thinner patients or children. Emphasis on depth and catheter length especially in obese patients.
• Point-of-Care Ultrasound (POCUS): Recommended for rapid diagnosis of pneumothorax and
hemothorax

C
• x is Major: Reinforces that massive hemorrhage can precede all other steps.
• Minimized Crystalloids: Advocates limiting crystalloids to avoid dilutional coagulopathy and
acidosis.
• Balanced Transfusion: Encouragement of early use of 1:1:1 ratio blood product transfusion
(RBCs, plasma, platelets) for hemorrhagic shock over crystalloid use.

D
• ASIA Impairment Scale: Now the standard for spinal cord injury classification, allowing detailed
documentation and prognostication.
• Early Recognition of Spinal Cord Injury Syndromes: Detailed syndromes ( Brown-Séquard
Syndrome, central cord, anterior cord syndrome) described for earlier diagnosis.

E
• Hypothermia and hyperthermia updated to include better assessment.
Special Populations

Geriatric Trauma

• Frailty over Age: Management emphasizes frailty index, not chronological age.
• Polypharmacy: Emphysis the significant impact of medications like
anticoagulants.

Trauma in Pregnancy

• Left Uterine Displacement: Continues to be a key intervention to relieve vena caval


compression.
• Multidisciplinary Planning: Stresses early coordination with obstetrics for
maternal-fetal outcomes

Ocular Trauma

• Chemical Injury Focus: Specific mention added with early irrigation as critical first-
line intervention.

Related knowledge pages

You might also like