TRAUMA Care is Getting F***ed
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Dr. Rich Hilsden, Trauma surgeon, discusses yet another change to the primary survey.
In his previous video, Dr. Hilsden discussed the addition of exsanguinating hemorrhage as the first element of the primary survey. This is a big change in trauma care. Advanced Trauma Life Support (ATLS) has for nearly 50 years begun with evaluating the airway. In addition to that change, we are now looking to add F to the end of the primary survey. F won't be a single F but rather will be many F's:
Facility
Futility
Family Presence
Future Goals
If you think there should be other F's as part of the primary survey comment down below. We would love to hear what you have to say.
For those playing the home game the Primary Survey would then look like this.
eXsanguinating Hemorrhage
Airway
Breathing
Circulation
Disability (I always call this neurological status)
Exposure (Some people add environment)
F's (Facility, Futility, Family Presence or support, and Future Goals)
As aways,
Thanks for watching.
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Пікірлер: 6
Very informative, thank you very much!
@RichHilsden
9 ай бұрын
Glad it was helpful! Thank you for the comment. Super appreciated.
Looking good brother! See you in Vancouver.
@RichHilsden
9 ай бұрын
Thanks! Looking forward to the week of trauma education
Înteresting. In EMS (and basically all emergency departments I've worked at/with) we made the change to include a critical bleed as the first step of our primary survey (cABCDE) a good many years ago, and changed it to xABCDE back in 2021 for clarity. I'm surprised that ATLS took so long to catch up, since all ALS-Courses I've visited so far also used xABCDE (although all of them were regional courses). I may be wrong, but I think I even remember that our ITLS advanced provider course a few years back already used xABCDE...
@RichHilsden
9 ай бұрын
I think it was a bit more critical that this change was made in the pre-hospital setting. ATLS is for doctors, or at least hospital based providers and there are a few reasons why the change was slower in this setting. Thanks for the comment!