As an ambulance physician, you and your crew are coming to a traffic accident. It is a crash of a passenger car into a solid obstacle. There was only a 29-year-old man in the driver's seat in the car. Looking into the interior of the vehicle, you can see the massive intrusion. He is now rescued by firefighters, has a neck collar and is placed on the spine board. He is conscious, complaining of pain in the left chest, abdomen and right leg. What will you do?
For access under the ATLS protocol, patient evaluation by the acronym ABCDE is crucial. A (airway maintenance with cervical spine protection), B (breathing and ventilation), C (circulation with haemorrhage control), D (disability: neurologic status), E (exposure: completely undress the patient, but prevent hypothermia). In this step, we start oxygen therapy (A), treat any tension pneumothorax (B) and ideally secure two IV lines (C).
A basic examination of the patient is always necessary. Results also determine the destination.
Try again Bury the patient
According to the ATLS protocol, at least two IV lines must be secured for a seriously injured patient in the risk of unpredictable deterioration.
The patient has open airways and is breathing spontaneously. But we have not evaluated his condition yet.