Resuscitation Resequenced: A Rational Approach to Patients With Trauma in Shock

Emerg Med Clin North Am. 2018 Feb;36(1):41-60. doi: 10.1016/j.emc.2017.08.005.


Trauma resuscitation is a complex and dynamic process that requires a high-performing team to optimize patient outcomes. More than 30 years ago, Advanced Trauma Life Support was developed to formalize and standardize trauma care; however, the sequential nature of the algorithm that is used can lead to ineffective prioritization. An improved understanding of shock mandates an updated approach to trauma resuscitation. This article proposes a resequenced approach that (1) addresses immediate threats to life and (2) targets strategies for the diagnosis and management of shock causes. This updated approach emphasizes evidence-based resuscitation principles that align with physiologic priorities.

Keywords: ATLS; Resuscitation; Shock; Shock index; Trauma.

Publication types

  • Review

MeSH terms

  • Advanced Cardiac Life Support / methods
  • Humans
  • Resuscitation / methods*
  • Shock / diagnosis
  • Shock / etiology
  • Shock / therapy*
  • Wounds and Injuries / complications
  • Wounds and Injuries / therapy*