TENTH EDITION
ATLS®
Advanced Trauma Life Support®
Student Course Manual
New to this edition
,ATLS®
Advanced Trauma Life Support®
Student Course Manual
, Chair of Committee on Trauma: Ronald M. Stewart, MD, FACS
Medical Director of Trauma Program: Michael F. Rotondo, MD, FACS
ATLS Committee Chair: Sharon M. Henry, MD, FACS
ATLS Program Manager: Monique Drago, MA, EdD
Executive Editor: Claire Merrick
Project Manager: Danielle S. Haskin
Development Editor: Nancy Peterson
Media Services: Steve Kidd and Alex Menendez, Delve Productions
Designer: Rainer Flor
Production Services: Joy Garcia
Artist: Dragonfly Media Group
Tenth Edition
Copyright© 2018 American College of Surgeons
633 N. Saint Clair Street
Chicago, IL 60611-3211
Previous editions copyrighted 1980, 1982, 1984, 1993, 1997, 2004, 2008, and 2012 by the
American College of Surgeons.
Copyright enforceable internationally under the Bern Convention and the Uniform Copyright
Convention. All rights reserved. This manual is protected by copyright. No part of it may be
reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic,
mechanical, photocopying, recording, or otherwise, without written permission from the
American College of Surgeons.
The American College of Surgeons, its Committee on Trauma, and contributing authors have
taken care that the doses of drugs and recommendations for treatment contained herein are
correct and compatible with the standards generally accepted at the time of publication.
However, as new research and clinical experience broaden our knowledge, changes in treatment
and drug therapy may become necessary or appropriate. Readers and participants of this course
are advised to check the most current product information provided by the manufacturer of each
drug to be administered to verify the recommended dose, the method and duration of
administration, and contraindications. It is the responsibility of the licensed practitioner to be
informed in all aspects of patient care and determine the best treatment for each individual
patient. Note that cervical collars and spinal immobilization remain the current Prehospital
Trauma Life Support (PHTLS) standard in transporting patients with spine injury. If the collars
and immobilization devices are to be removed in controlled hospital environments, this should
be accomplished when the stability of the injury is assured. Cervical collars and immobilization
devices have been removed in some of the photos and videos to provide clarity for specific skill
demonstrations. The American College of Surgeons, its Committee on Trauma, and contributing
authors disclaim any liability, loss, or damage incurred as a consequence, directly or indirectly,
of the use and application of any of the content of this 10th edition of the ATLS Program.
Advanced Trauma Life Support® and the acronym ATLS® are marks of the
American College of Surgeons.
Printed in the United States of America.
Advanced Trauma Life Support® Student Course Manual
Library of Congress Control Number: 2017907997
ISBN 78-0-9968262-3-5
TO TABLE OF CONTENTS
, DEDICATION
We dedicate the Tenth Edition of ATLS to the memory of Dr. Norman E. McSwain Jr. His dynamic, positive, warm,
friendly, and uplifting approach to getting things done through his life’s work is a constant inspiration to those whose
lives he touched. His tenure with the American College of Surgeons Committee on Trauma (COT) spanned almost
exactly the same 40 years of the ATLS course.
Dr. McSwain’s time with the COT led him down a path where, without a doubt, he became the most important surgical
advocate for prehospital patient care. He first worked to develop, and then led and championed, the Prehospital Trauma
Life Support Course (PHTLS) as a vital and integral complement to ATLS. Combined, these two courses have taught
more than 2 million students across the globe.
Dr. McSwain received every honor the COT could bestow, and as a last tribute, we are pleased to dedicate this edition of
ATLS to his memory. The creators of this Tenth Edition have diligently worked to answer Dr. McSwain’s most common
greeting: “What have you done for the good of mankind today?” by providing you with the Advanced Trauma Life
Support Course, 10th Edition, along with our fervent hope that you will continue to use it to do good for all humankind.
Thank you, Dr. McSwain.
Sharon Henry, MD
Karen Brasel, MD
Ronald M. Stewart, MD, FACS
TO TABLE OF CONTENTS
ATLS®
Advanced Trauma Life Support®
Student Course Manual
New to this edition
,ATLS®
Advanced Trauma Life Support®
Student Course Manual
, Chair of Committee on Trauma: Ronald M. Stewart, MD, FACS
Medical Director of Trauma Program: Michael F. Rotondo, MD, FACS
ATLS Committee Chair: Sharon M. Henry, MD, FACS
ATLS Program Manager: Monique Drago, MA, EdD
Executive Editor: Claire Merrick
Project Manager: Danielle S. Haskin
Development Editor: Nancy Peterson
Media Services: Steve Kidd and Alex Menendez, Delve Productions
Designer: Rainer Flor
Production Services: Joy Garcia
Artist: Dragonfly Media Group
Tenth Edition
Copyright© 2018 American College of Surgeons
633 N. Saint Clair Street
Chicago, IL 60611-3211
Previous editions copyrighted 1980, 1982, 1984, 1993, 1997, 2004, 2008, and 2012 by the
American College of Surgeons.
Copyright enforceable internationally under the Bern Convention and the Uniform Copyright
Convention. All rights reserved. This manual is protected by copyright. No part of it may be
reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic,
mechanical, photocopying, recording, or otherwise, without written permission from the
American College of Surgeons.
The American College of Surgeons, its Committee on Trauma, and contributing authors have
taken care that the doses of drugs and recommendations for treatment contained herein are
correct and compatible with the standards generally accepted at the time of publication.
However, as new research and clinical experience broaden our knowledge, changes in treatment
and drug therapy may become necessary or appropriate. Readers and participants of this course
are advised to check the most current product information provided by the manufacturer of each
drug to be administered to verify the recommended dose, the method and duration of
administration, and contraindications. It is the responsibility of the licensed practitioner to be
informed in all aspects of patient care and determine the best treatment for each individual
patient. Note that cervical collars and spinal immobilization remain the current Prehospital
Trauma Life Support (PHTLS) standard in transporting patients with spine injury. If the collars
and immobilization devices are to be removed in controlled hospital environments, this should
be accomplished when the stability of the injury is assured. Cervical collars and immobilization
devices have been removed in some of the photos and videos to provide clarity for specific skill
demonstrations. The American College of Surgeons, its Committee on Trauma, and contributing
authors disclaim any liability, loss, or damage incurred as a consequence, directly or indirectly,
of the use and application of any of the content of this 10th edition of the ATLS Program.
Advanced Trauma Life Support® and the acronym ATLS® are marks of the
American College of Surgeons.
Printed in the United States of America.
Advanced Trauma Life Support® Student Course Manual
Library of Congress Control Number: 2017907997
ISBN 78-0-9968262-3-5
TO TABLE OF CONTENTS
, DEDICATION
We dedicate the Tenth Edition of ATLS to the memory of Dr. Norman E. McSwain Jr. His dynamic, positive, warm,
friendly, and uplifting approach to getting things done through his life’s work is a constant inspiration to those whose
lives he touched. His tenure with the American College of Surgeons Committee on Trauma (COT) spanned almost
exactly the same 40 years of the ATLS course.
Dr. McSwain’s time with the COT led him down a path where, without a doubt, he became the most important surgical
advocate for prehospital patient care. He first worked to develop, and then led and championed, the Prehospital Trauma
Life Support Course (PHTLS) as a vital and integral complement to ATLS. Combined, these two courses have taught
more than 2 million students across the globe.
Dr. McSwain received every honor the COT could bestow, and as a last tribute, we are pleased to dedicate this edition of
ATLS to his memory. The creators of this Tenth Edition have diligently worked to answer Dr. McSwain’s most common
greeting: “What have you done for the good of mankind today?” by providing you with the Advanced Trauma Life
Support Course, 10th Edition, along with our fervent hope that you will continue to use it to do good for all humankind.
Thank you, Dr. McSwain.
Sharon Henry, MD
Karen Brasel, MD
Ronald M. Stewart, MD, FACS
TO TABLE OF CONTENTS
