The Skeptics Guide to Emergency Medicine SGEM Xtra: This One Goes to 11 – ATLS 11th Edition
Mar 28, 2026
Dr. Robert Leeper, a trauma surgeon and ATLS instructor who trains clinicians in trauma care. They unpack ATLS 11’s big shift to prioritize life‑threatening hemorrhage first. They cover correcting shock before intubation, a new penetrating trauma chapter, expanded geriatric and system-focused content, and updated training methods and transfer mnemonics.
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Episode notes
Hemorrhage First XABCDE
- ATLS 11 adds X to make exsanguinating hemorrhage the first priority before airway in select trauma patients.
- This formalizes early tourniquet use, direct pressure, and hemostatic adjuncts as first-line interventions, reflecting military-to-civilian lessons.
Stabilize Physiology Before Intubation
- Optimize hemodynamics before rapid sequence intubation in unstable trauma patients to avoid peri-intubation hypotension and arrest.
- Use noninvasive support, correct shock first, and plan intubation as a controlled procedure when possible.
ATLS Expands To System And Public Health
- ATLS 11 reorganizes into resuscitation, trauma system context, and specific injury patterns, expanding focus beyond the first 15 minutes.
- New chapters include trauma system design, injury prevention, trauma-informed care, and communicating serious news.