Trauma Assessment - Teaching Scenario 

Student: "I'm now checking breathing." Dungeon Master: (rolls D12) "Breathing is normal."

Thank you very much for this presentation. I would like to congratulate to the entire team for making such an excellent and complete video based on ATLS principles. I completely disagree with the comment on its outdated practice, as I am an ATLS trained professional and did not find any contradicting move in it. I would recommend this to every one including practicing EM physicians and the one who are preparing for the UK based EM boards.

This is a training video. Clearly in practice the speed and order may differ but the structure of this ATLS-based system ensures nothing is missed.

Thanks very much for this video presentation, especially with the scenario training that Medical students do go through, and should continue to go through, as to always prepare for the real thing when it happens. Excellent training procedure and awareness, job well done. Sincerely Matthew

Thanks for you comment. At the time of production all videos were scripted in accordance with ATLS guidelines. However, guidelines do adapt slightly over time so these videos may contain minor differences from the current ATLS algorithm.

This video is for a very specific purpose and that seems fairly obvious to me that it is not intended to cover all eventualities from warfare to the tertiary emergency dept. There are clearly circumstances where the ATLS principles need adaptation depending on locality and availability of resources. I am interested in the hostility and chest thumping nature of many of the postings related to this video and would like to commend the professionalism of those replying to the comments made.

Medicine is not just a science, it's an art.

Excellent educational video.

Thank you very much for doing the video. The pragmatic ATLS approach is shown. Thank you again!

If your patient is answering questions he is probably breathing. Look Listen and Feel is not needed for airway.

Great effort and video series , thx

Thanks for the video. I served 3 tours as a team medic, and have seen my share of field trauma.Unless one has taken the ATLS course, passed both the "hands on portion" of ATLS, the written ATLS test , and have some years experience in a ED trauma setting your expertise as a critic is fundamentally flawed. Again, thank you for the video.

Good job ,neck veins very important to describe as it gives alot of informations. I m also wondering why to order amylase for the trauma patient early

If you're going to cover something up, such as with a c-collar, check the area FIRST. No matter what ATLS says. Do a quick scan for major bleeding, regardless of what ATLS says. Etc.

Great video but for some reason it stops playing after 9:30. ??

Excellent

great job

Thanks for this video Karbala medical college ...

thanks

brilliant

I like how he is constantly getting permission from the patient to do any work.

Thank you for them!

Putting on a c-spin colar before B?

Spent about 2 minutes putting caller on ...in mean time patient is bleeding out.

Nice

Percussions in A.T.L.S. ?

1) airway+ collar 2) oxygent

hi dont we put the collar on first and then check the breath sounds?

I wonder why he didn't choose a pair of gloves that fit him properly?

Do we check for A and B when patient can talk? or we go straight to C?

Why do you need to "look listen feal" if he is talking to you?

need some O2 in that bag on the NRB!

Your out of date guys. Also if you stabilise the neck and do the checking of airway at the same time the head and neck...........??

seriously got go through all that to get to the BP and HR?

No G.C.S. score?

every stage i was hoping, ok now he will find what the patient is suffering from! now there will be a twist and he will discover a major life threat... i wish every patient i wheel into the ER would get this sort of care and treatment.

Just for you guys to know, these procedures are outdated. It's not according to the 2010 AHA/ACC and the last ATLS. So be careful..

Spo2 99% why is the patient on 15 litres of 02? Thorough exam but we have forgotten the basics

I worked level one trauma as a nurse at leading facilities such as Denver General and Oregon Health Sciences many years. I was going to be a flight nurse. ER medicine around trauma is based on mechanism, and DG coined the "golden hour" of trauma where I trained. I later went on to have the procedure numerous times called ECT or electroshock after a bad reaction to an SSRI anti-depressant. I lost memories of my job training and college education. As a result of repeated traumatic brain injuries secondary to electrical mechanism of trauma I ended up of permanent disability. I know based on my years of experience just as most providers know, that this results in TBI at best. My peers that have had this procedure are evolving in symptoms of CTE and ALS years out from initial injury. I cannot understand the silence of providers knowing of this harm taking place most likely at your facility. My peers I worked with for years and highly respected cover for their peers and facilities vs. recalling their oaths taken to warn, protect, and not cause harm. You in your silence passively condone this, while patients are being harmed. I ask you to have conversations to address this. Law suits are taking place currently on a national level around devices used in this procedure, but the harm continues. Advocate for patients please as this is purely electrical trauma, being passed off as useful to vulnerable and hurting patients. Increase in suicide following this procedure because many cannot find help to address damages. ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-7BaWGCwnxLg.html

Never Secure the head to anything before the body is strapped on !!!!!!!!!!!

Why oxygenate at the beginning?

why does the nurse look angry?

I think that Mr " Isis Rodriguez" is the most rude and obnoxious person on You Tube. Very sad that we allow people like that to put such comments. He is a shame. I hope this" person" is not a doctor! If so I would scrap it from the medical council instantly.

breathing 4:55

expouser 9:11

circulation 7:14

Too much slow, but this is a demo. Very interesting.

8:13 disapility

why run fluids when obs. are normal? O2 continued after Sats. of 99% logical for an Osci perhaps but not good for the patient.

It should be fast.. Not slow as shown. We should resuscitate imediately

okay grammar Natzi - actually both "practise" and "practice" have the same meaning - look it up. secondly, he does have help and she is just standing there without direction. thirdly, not ungrateful, just frustrated at the lack of skill in this video. 25 years in EMS between SAR, Combat medic and Fire and/or medic capacity, I am pretty sure I know what I am doing. I stand by my assessment and anyone with the same training as me would agree also

Y can't he call the nurse by her damn damn!

ungrateful much? Firstly, in a real ED there wouldn't be just one guy doing everything so things could be done simultaneously, with just one guy this is correct. Secondly, it's practise, "practice" is a noun, what you said doesn't make any sense. that's like me saying I'll chair down on the sofa. Thanks for posting these videos.

Not very good.

Coming from a military back ground I personally think this demo was not up to standard. 1. In the military we go by the pneumonic C-ABC or MARCH in other words check for massive haemorrhage first especially in a patient that has sustained trauma. Absolutely no good what so ever checking C spine, airway etc when the patient could be leaking life blood every where, blood on the floor and 4 more. Secondly why the need to give oxygen? Thirdly why the need to give IVI fluids? If the patient has a good palpable radial pulse, if you give IVI fluids then any clotting going on will be blown! I personally think this training video is out of touch and needs addressed.

Paramedics would have usually already exposed the patient and conducted a full head-to-toe.

I unfortunately couldn't help laughing at the way he said trachea. He made it sound like a car dealership. Like TRA-KIA, idk IKEA, maybe I'm just immature.

alot of times there is no reason to expose a patients privates,if the patient is talking an knows whats hurting an not.. hospitals get carried away when they expose patients . respect the patients privacy...

hmmm, doing look, listen and feel on a conscious pt talking to him. 15L o2 without checking pulse ox, maybe ask the pt what happened, where he is and what day of the week is, wastint time immobilizing head without checking for any obvious life threatening injuries, hmmm, now the pulse ox at 3 minutes, probably could get a better look at the back before he immobilized the head, 5:12, rechecking the pt still without asking what happened and not finishing primary assessment. and b/p

6:30 finally asking about external bleeding and checking pelvis and legs, good thing he didn't have a femoral bleed. grips and pushes would have been nice by now, oh, at 8:00 finally doing pupils. 8:38 finally exposing pt, cutting off clothes - I would have been fired if It took me that long to strip and flip. I guess that is why doctors "practice" medicine

thanks