ATLS® 第10版 更新摘要

ATLS 10th Edition Compendium of Change from Sun Yai-Cheng

ATLS 10th Edition Compendium of Change

Primary Survey

Airway Maintenance with Restriction of Cervical Spine Motion

• “cervical spine protection” changed to ”Restriction of Cervical Spine Motion”
• RSI changed to ”Drug Assisted Intubation”

Breathing and Ventilation 

Circulation with Hemorrhage Control

• Initial resuscitation: Adult: 1 L isotonic solution; Child < 40 kg: 20 ml/kg
• Tranexamic acid: 1 g over 10 min within 3 hr, then 1 g over 8 hr
• Hemorrhagic shock classification table amended: Base excess 

Thoracic Trauma

• Life threatening chest injury: flail chest out, tracheobrochial injury now in
• Tension pneumothorax:
• Needle thoracocentesis
• 5th  ICS mid-axillary line for adult
• UNCHANGED 2nd ICS mid-clavicular line for child
• 28-32 Fr chest drain for hemothorax (not 36-40 Fr)
• eFAST (extended FAST): seashore, bar code, or stratosphere sign in M mode
• Aortic rupture management with Beta Blocker (esmolol): goal heart rate < 80 bpm and MAP 60-70 mmHg
• Algorithm for circulation arrest approach

Abdominal and Pelvic Trauma

• Palpation of prostate gland no longer recommended for urethral injury

Head Trauma

• Classification: “minor” changed to “mild” head trauma
• Detailed guidance on SBP management
• Maintain SBP at ≥ 100 mmHg for patients 50-69 years or at ≥ 110 mmHg for patients 15-49 years or older than 70 years.
• Anticoagulation reversal guidance

Spine and Spinal Cord Trauma

• New myotome diagram

• Canadian C-Spine Rule (CCR) and NEXUS Criteria

Musculoskeletal Trauma

• Highlighting risk factor of bilateral femur fractures

Thermal Injury

Paediatric Trauma

• Pediatric Emergency Care Applied Research Network (PECARN) Criteria for Head CT

Transfer to Definitive Care

• Specific mention of avoiding CT in primary hospital
• SBAR template for communication

Mobile ATLS: New to this edition

Royal College Surgeons ATLS course 時程公告：

2018年 2月   以前，ATLS 第 9 版
2018年 3月到 5月，ATLS 第 9 版 + 第 10版 重點導讀
2018年 6月   以後，ATLS 第 10版

相關文章

Major Changes In The ATLS 9th Edition 

ATLS 8e, The Evidence for Change