Abstract

In this issue of EM Practice Guidelines Update, we review the changes and additions to the Advanced Trauma Life Support (ATLS) guidelines leading to the 8th Edition. Since its inception in 1978, ATLS has improved trauma care internationally by serving as a standard for focused trauma assessment and management as well as a language that allows physicians in emergency departments (EDs) and on trauma teams to work synchronously and provide consistent trauma management.

Practice Guideline Impact

• A rectal examination is not mandatory for all trauma patients. It can be performed selectively based on clinical judgment.
• ATLS guidelines now recognize the value of the CO₂ detector, laryngeal mask airway (LMA), and gum elastic bougie in airway management of the trauma patient.
• The guidelines clearly state that there is insufficient evidence to advocate for steroids in spinal cord trauma.
• Clear criteria exist for when to screen for blunt carotid and vertebral vascular injury via computed tomography (CT)-angiography.