An important ATLS concept is that treatment is focused on the greatest threat to life. Making a definitive diagnosis and doing a detailed history and physical exam are less important at the beginning. The initial approach to the trauma patient is the primary survey, the ABCD(EFG)s with appropriate resuscitative efforts being applied simultaneously: Airway - assess airway patency; immobilize the cervical spine; intubate for GCS <= 8 or absent gag reflex. Breathing - assess adequacy of chest rise, RR, pulse ox; if intubated, ventilate at 8-10 breaths/min. Circulation - assess HR, skin color and temperature, capillary refill; assess BP; establish IV access; give isotonic fluid bolus 20 cc/kg. Disability - also known as 'Da Brain'; assess GCS; check blood sugar if altered mental status; assess pupil size and reactivity. Exposure - fully undress patient to assess for hidden injury. look for signs of depressed or basilar skull fracture. Foley - insert bladder catheter unless suspected urethral disruption in which case get emergency urologic consult. Gastric - insert NG tube or, if maxillofacial injury, an OG. "Clinical" Pages: 1 2 3 4 Next