ABSTRACT
The Advanced Trauma Life Support course has established the value of a standardized approach to trauma assessment and management, especially for the lone practitioner faced with one or more patients who have sustained severe injuries. Airway obstruction in an unconscious patient can usually be relieved by lifting the jaw forwards, but it may require the insertion of a finger into the mouth to extract debris. Mouth-to-mouth resuscitation should be started immediately if the patient remains cyanosed or apnoeic after the airway has been cleared. An unconscious or immobile patient can rapidly become hypothermic, which exacerbates coagulopathy and acidosis. All patients who are unconscious or suspected of having multiple or serious injuries should be admitted directly to the resuscitation area of the accident and emergency department. Monitoring of the Glasgow Coma Scale score must be carried out at frequent intervals in comatose patients with a score of 8 or less.
