Emergency Medicine and Acute Care

Trauma is a global burden and one of the most common reasons for mortality and morbidity worldwide. With the advance in urbanization, the incidence of trauma has increased a lot. Th is magnitude is aff ecting the young generation more than the extremes of the age. Trauma affl  icted critical patients need a timely management and if provided in time the outcome is too good. Th e management needs insight about the presentation, mechanism and other associated factors. Th ese all aspects need to be kept in mind while resuscitating such a critically ill patient. Since so many years the age old ATLS guidelines help us in managing the trauma patients and it serves well in achieving good outcome for such cases. But since a lot has changed in fi eld of medicine due to a great quantum of research, trauma management also needs to be updated regularly. Th e ATLS guidelines do keep us giving new updates in management of trauma cases but such guidelines take years together to be updated. While as applying evidence-based approach in resuscitating critically ill trauma cases makes us to be updated to the best and gives us the best primary outcome in such cases. And even applying the EB approach keeps us in the limelight of best practices of resuscitation. So many things are not touched in ATLS guidelines which can be brought into clinical practice as they have been well studied in various RCTs, meta-analysis or systematic reviews, e.g. resuscitation sequence intubation, newer ventilation strategies, fl uid management and initiation of blood products transfusion, MTP protocol, damage control resuscitation and damage control surgery, etc. Time is here that we need to think out of the box while managing our precious patients in day to day life.