ATLS is an emergency care protocol for patients with trauma, consisting of a comprehensive system of standardized procedures. The term polytrauma is used to refer to a patient with simultaneous injuries of at least two body systems, at least one of which (or their combination) is life-threatneing. The creation of the ATLS program has resulted in a consistent approach to patients with trauma and the creation of trauma centres - specialized hospitals/departments which provide comprehensive care for patients with severe trauma.

In pre-hospital care, healthcare professionals have to identify „Triage Positive Patients“ - patients meeting defined criteria for transport directly to a trauma centre. These criteria include failure of vital functions, and site or mechanism of injury.

The ATLS concept emphasizes that death of a patient occurs in a certain logical sequence. The ABCDE mnemonic sets the basic priorities for primary assessment and defines the specific individual examinations and interventions that are universal for all traumas.

Airway – Assess the airway patency, or need to secure it. With the same priority we assess and carefor stabilizing the cervical spine..   

Breathing – Even patent airways do not guarantee adequate gas exchange. Sufficient function of the lung, chest wall and diaphragm are needed. In the case of a trauma patient, ventilation is particularly vulnerable to tension pneumothorax or possible massive hemotorax, which must be resolved by urgent thoracic puncture/drainage.

Circulation – the most common cause of shock in patients with trauma is blood loss with subsequent hypovolemia. Bleeding must be identified and resolved. A crucial tool for this assement is a bedside ultrasonographic examination called FAST (Focused Assessment with Sonography for Trauma). Important sources of bleeding include fractures of the pelvis and long bones.

Disability – Rapid evaluation of neurological status. We determine the status of consciousness (Glasgow Coma Scale classification), pupil reaction and potential spinal injury.

Exposure – Complete stripping of the patient and detailed examination of all parts of the body (even from behind).  After complete assessment cover the patient with a heated blanket.

After completing the primary examination urgent surgical procedures, called Damage Control Surgery, are performed, if required by the nature of the injuries. Intervention proceeds according to the following priorities - LIFE SAVING ˃ INTEGRITY˃ FUNCTION

After an early surgical procedure, the patient is taken to the intensive care unit. Here the priority is to achieve thermal homeostasis, optimize circulation, modify the patients acid/base and mineral balance, and minimize secondary post-traumatic damage.