Primary Survey ATLS Video

Isn’t hare traction contraindicated for an open femur, and definitely in an unstable pelvic fracture

Great video. Hard to do these live on a video. Only correction: Abdominal binder has become standard (although I've used a sheet before). OGT is contraindicated until CT head to r/o basilar skull fracture, so OGT best. I would also prefer to see the trauma team (even at a small hospital) an ED tech, house supervisor (scribe?), lab, x-ray outside door.

Localized to pain is a 4????

Betsy forgetting to put that IV in.. Would had pushed 1-2L in already with that BP and had that EMS give me his phone or wallet for POA.. smart putting the xray board down while he was rolled.

would had made copies of the xray scans myself and just tell the nurses to focus on NG and foley because thats too many orders at once. something will be forgotten.

helpful

Meeting with you you

yeah GCS is 8 not 7 if I'm not mistaken.

Very nice work

Really great video. Stands the test of time. Thank you!

Only 3 people and there is no other trauma team coming for help? thats must be difficult

Chest tube before or just at the time of intubation in this case.

Thanks you!!!

How about we get some blood to give prior to intubation that can cause his hypotension to worsen and kill him...

Thank you 🙏🏻

outstanding

This doesn't look like ER or Chicago Med at all :)

Very good

Localizes pain is M5, not M4... ;-) The GCS is not so easy to use in the ER...

Nice sim but not perfect.
Beneficial to watch nonetheless.
I think the benefit from this video is to critically review the correctly and incorrectly performed elements

Criticism from my side:
-Incorrect Primary survey sequence: A,C,E,D (GCS is part of secondary survey; use AVPU for now)
- air transport plans: no note made for ETT cuff air to be replaced for sterile water
-foley cath can be done after secondary survey; also contrainidicated in pelvic fracture

Positive remarks
- always refer telephonically if transfer needed, clearly depicted
-great log roll technique and order
-good team dynamics at play

I wonder why E-FAST was NOT performed. Very simple and quick testing modality with a high sensitivity and specificity and non-invasive procedure

I’m waiting for the doctor to order FAST sono 😬

Who is documenting??!😅😅

keeeep Going dr💕

Great video ,Thanks.

So correct me if I'm wrong, but he seems to intubate this patient without giving any sedation or analgesia, and THEN assesses GCS and finds that the patient is localising to pain - is this scenario even possible?! I'm genuinely curious, because the only time I've seen a patient intubated without giving any sedation is when they are in cardiac arrest. Surely if this patient was localising to pain he would have pulled the tube out when the doc clearly lets go of the tube before it gets secured? I get that they are trying to emphasise simultaneous assessment and management, but I think it's worth arguing that unless the airway is about to be lost in the next minute then it would be better to complete the primary survey and begin optimising the patient's oxygenation / haemodynamics / positioning / etc prior to attempting intubation (the subject in this video has also has terrible positioning for laryngoscopy). Apart from those criticisms I think the video is quite good - he demonstrates good clear communication, closed loop handover etc.

what part of primary survey does pushing on the belly belong in?

Love from er department

No urethral or suprapubic catheter to monitor urine output?

After watching this for the umpteenth time; I just noticed the Rad Tech's photo is on page 12 Figure 1-5 of the 10th Ed ATLS Student Manual.

little tense and erratic but I like it...

Thanks

C spine collar with possible neurotrauma? And why would you fill even more with saline when there is an obvious bleeding? Filling the pt. would only raise blood pressure increasing the bleeding.

Thank you for the video! Appreciate it.

why not a FAST Sono?

I don't think you should log roll a patient that has an open femur # .

Good video of ATLS primary management

pelvic fracture transurethral catheter no mention of high riding prostate on PR

Byhuuju

he jumped from airway to circulation. what about b? wht about tension pneumo, hemo open pneumo

Thank you. Very informative.

EMT"S didn't use a pelvic binder?

nice Videos

What about the FAST-sonography. Point nr 2, if you think there could be a middleface fracture, you should use the nasopharyngeal access to intubate (I suppose this video follows the Secondary Survey ATLS).

No more Cricoid people!

very different to 2015 atls moulage

Log roll on a pelvic fracture?

Shouldn't saturation be over 98% in suspected brain injury?

This is how you bring people back from death. God bless you sir, and I hope this unfortunate chap survived his unlucky accident.