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This blog highlights the shift in trauma care from needle decompression to finger thoracostomy for treating tension pneumothorax. It explains how needle catheters often fail due to chest wall thickness or kinking. In contrast, the finger thoracostomy offers a reliable, tactile approach. By entering the pleural space directly, providers can definitively relieve pressure and confirm lung re-expansion, making it a critical, life-saving skill in modern ATLS protocols.

To confidently pass the ATLS written examination, candidates should adopt a rigorous, two-phase methodology. First, build a structured clinical foundation by studying chapter-by-chapter. Second, develop the ability to rapidly context-switch and manage cognitive load by practicing full-length mock tests under strict exam conditions.

Current best-practice evidence on tube size, decompression technique, occult pneumothorax and antibiotics - and what it means for the ATLS candidate.

A growing body of evidence suggests that rigid adherence to Manual In-Line Stabilisation (MILS) during trauma intubation significantly degrades glottic views, increasing the risk of profound hypoxia. This post explores the modern consensus on prioritizing the airway over theoretical spinal cord protection, the game-changing role of videolaryngoscopy, and how candidates should apply these evolving guidelines within the framework of the ATLS written assessment.

The archetypal trauma patient - the young man pulled from a wrecked car, hypotensive and tachycardic, the patient around whom the primary survey, the trauma team activation call, and decades of trauma system design were constructed - is no longer the typical major trauma patient in the United Kingdom or in most high-income countries.

Why xABCDE Is a Syntax, Not a Language - and What Linguistics Teaches Us About Becoming Fluent in Resuscitation

As UK councils install public bleed-control cabinets during Knife Crime Awareness Week, the evidence for bystander tourniquets and wound packing is more contested than the headlines suggest. We examine what ATLS candidates must know.

The first randomised trial of augmented mean arterial pressure in acute spinal cord injury found no benefit and signals of harm, unsettling a guideline-driven consensus that has shaped trauma practice for more than two decades.

Medical educators must critically evaluate the construct and predictive validity of these expensive simulators. We must ensure that curriculum design prioritizes holistic, cognitive, and team-based training over the alluring, but potentially superficial, appeal of hyper-realistic physical models.

The two-litre crystalloid bolus, once the unchallenged cornerstone of trauma resuscitation, is now one of the most contested teachings in acute care.

Resuscitative thoracotomy remains a procedure defined by extremes: extraordinary benefit in a narrow population, and near-certain futility in everyone else. The evidence supports its use in penetrating thoracic injury with witnessed arrest and recent signs of life, where it addresses a mechanically reversible cause of cardiac arrest.

Whole-body CT has become routine in many major trauma centres based on compelling observational data from the German TraumaRegister, yet the only randomised controlled trial - REACT-2, published in The Lancet in 2016 — found no mortality benefit over selective ATLS-guided imaging, with identical 16% in-hospital death rates in both groups. For ATLS candidates, understanding this unresolved debate between comprehensive and selective imaging is increasingly important for clinical practice and viva.