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.

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One Response to ATLS EVOLVING

  1. Hi, i come here because an article on slydiving risk on skydivemag. Im a medical practicioner, emergency physician (here in Chile default is General Practicioner as i have experience in pre-hospital i dont have the formal specialty).

    I recently went on a ATLS course provided by my employer (free of charge) So i knew that the will say old stuff things like 2LTS saline, and then more saline!!!

    I also prosgraduate of an intensive care diplomate with cracks over the world. So well. Its a surgeon thing, ATLS. Not good but maybe better than nothing.

    Well thanks for your articles. Blue skyes and safe landings.

    PD: im also interested in how we can mix and develop our sports with medicine, in that line im going to a world congress in novemeber in edinburgh ( If you are interested, or in another ways to connect this to wonderfull passions.

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