Atls (Advanced Trauma Life Support) Teaching Protocol

Need for Ventilation

Unconscious GCS ≤ 8	Apnea Neuromuscular paralysis Unconscious
Severe maxillofacial fractures	Inadequate respiratory effort Tachypnea Hypoxia Hypercarbia Cyanosis
Risk for aspiration Bleeding Vomiting	Severe closed head injury with need for hyperventilation
Risk for obstruction

• 
  Assessment:
  

• 
  Ascertain patency
  
• 
  Rapidly assess for airway obstruction
  
• 
  Foreign bodies, facial / mandibular / tacheal / larygeal fractures.
  

• 
  Management:
  

• 
  Chin lift / jaw thrust maneuver
  
• 
  Clear the airway of FB
  
• 
  Insert an orotracheal / nasopharyngeal airway
  
• 
  Establish a definitive airway
  

1. 
   Orotracheal / nasotracheal intubation
   
2. 
   Surgical cricothyroidotomy
   

• 
  Jet insufflation
  

• 
  Maintain the cervical spine in a neutral position with manual immobilization as necessary when establishing an airway
  
• 
  Immobilization of the c-spine with appropriate devices after establishing an airway.
  

•