UMEM Educational Pearls

Category: Trauma

Title: Circulation before Airway or Breathing in Trauma Care

Keywords: circulation, trauma, hemorrhage, atls (PubMed Search)

Posted: 5/20/2023 by Robert Flint, MD (Emailed: 5/21/2023) (Updated: 4/22/2024)
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It is time to abandon the ABC's that ATLS teaches and move to hemorhage control (circulation) as well as resucitation before we deal with airway in the majority of trauma patients.  Tounriquets save lives. Pelvic binders save lives. Blood transfusion (whole blood) saves lives. Poisitive presssure ventilation, sedativies, and decreasing sympathetic drive in hypoternsive patients makes their hypotension worse. 


Please consider changing to a CAB approach to the hyhpotensive trauma patient. 


Ferrada PDissanaike S. Circulation First for the Rapidly Bleeding Trauma Patient—It Is Time to Reconsider the ABCs of Trauma Care. JAMA Surg. Published online May 17, 2023. doi:10.1001/jamasurg.2022.8436