Developed by the American College of Surgeons Committee on Trauma following a 1976 plane crash that highlighted deficiencies in trauma care, the course is now a global standard used in over 60 countries. The core philosophy involves treating the greatest threat to life first, not allowing a lack of definitive diagnosis to delay treatment, and recognizing that a detailed history is not essential to begin evaluation.

Initial Assessment and Primary Survey The hallmark of ATLS is the primary survey, structured around the ABCDE mnemonic:

• Airway: Assessment of patency while strictly maintaining cervical spine motion restriction. A definitive airway (cuffed tube in the trachea) is required for patients with airway compromise or a Glasgow Coma Scale (GCS) score of 8 or lower.

• Breathing: