Initial trauma assessment and resuscitation

Abstract

In the United States, accidental injury is the leading cause of death for people between the ages of 1 and 44. Traumatic injury of all causes is responsible for more than 170,000 deaths annually. More than 42 million people will seek medical care due to intentional or accidental trauma this year, at an annual national cost of greater than $406 billion dollars. The injured patient must be assessed quickly and treatment of life-threatening injuries begun immediately. A systematic approach to this evaluation assures that the most critical injuries are identified early and that potentially lethal injuries are not missed. The American College of Surgeons Advanced Trauma Life Support (ATLS) course promotes the "ABCDE" primary survey sequence, and this is the most widely accepted approach to the initial evaluation of the trauma patient. This strategy also provides a framework for reevaluation if the patient’s condition deteriorates, redirecting the physician back to the start of the algorithm in search of a missed or worsening injury.