Early Care of Polytraumatized Patients: A Framework for Orthopaedic Surgeons

The role of orthopaedic surgeons during trauma activations is vague and often underused. Advanced trauma life support (ATLS) is a training program and framework for performing initial life- and limb-threatening interventions. ATLS was created by Dr. James Styner, an orthopaedic surgeon, to systematically evaluate and treat trauma patients after his family received suboptimal initial care following a plane crash in 1976. There are numerous orthopaedic assessments done during the ATLS primary and secondary surveys. Understanding hierarchy and sequencing of these interventions may enhance orthopaedic integration into the broader resuscitation and surgical efforts. ATLS training is not standard in US orthopaedic residency programs. Fundamental understanding of ventilation parameters and resuscitative protocols enhance decision making for the extent of orthopaedic surgical intervention acutely. Defining indications for emergent interventions among other surgical specialties improves multidisciplinary surgical planning. This review aims to answer the question, "What needs to be done now using the ATLS survey framework and how can an orthopaedic surgeon contribute?" Furthermore, this review intends to introduce ATLS for orthopaedic surgeons in supportive roles with surgical and nonsurgical responsibilities by describing basic protocols and evidence of benefit.