We’ve often critisised ATLS. Part of it because many healthcare workers take the ATLS manual as divine law. And many of them don’t keep up with the changes in the new ATLS editions – so they cling to even older dogma. Pretty much everybody has stopped giving 2 L of saline, but many will still say things like the digital rectal exam (DRE) is manadatory in ATLS. It isn’t. Or a hard cervical collar is mandatory. It isn’t.
ATLS is now at the 9th edition, and the 10th edition is around the corner. What other dogma will they get rid of, and what will they add, and get more in line with current trauma thinking? Well, here’s a teaser:
They have moved the temporary measure of needle decompression from the thick pectoral muscles, and out on the side of the chest – although a finger thoracostomy would be more decisive and definitive.
They’ve even gotten rid of the high riding prostate sign, although they should have gotten rid of, or at least toned down the whole DRE – and log roll for that matter.
Now, ATLS is a big organisation and not as fast moving and flexible as we would want to, but they are moving forward. For their 10th edition, it seems they will be catching up on many important areas.