Advanced trauma and life support for the MRCS

Trauma remains the leading cause of death in the under 40 year olds, with road traffic accidents and blunt trauma being the predominant mechanisms in the Western world. This article will reinforce the ATLS method, with initial assessment progressing from 'A' to 'B' to 'C' and so forth, with systematic re-assessment starting from 'A' after any changes in physiology or interventions. It will also aim to introduce some of the more recent changes in trauma care such as massive transfusion protocols, treatment of traumatic cardiac arrest, basic management of limb-threatening conditions (open fractures and compartment syndrome), damage control surgery versus early total care, and the Major Trauma Network. When managing trauma patients the primary survey and immediate life-saving interventions should be undertaken promptly and at times in trauma teams simultaneously.