A 24-year-old male is brought to the emergency department via ambulance following a high-speed motorcycle collision. He was found approximately 30 feet from his motorcycle. On arrival, he is moaning but not following commands. His blood pressure is 80/40 mmHg, and his heart rate is 132/min. Arrange the following steps of his initial trauma evaluation and management in the most appropriate chronological order.
- 1Secure the airway while maintaining strict in-line cervical spine stabilization.
- 2Auscultate bilateral lung fields and assess chest wall excursion.
- 3Establish access with two large-bore peripheral intravenous catheters and initiate fluid resuscitation.
- 4Perform a brief neurologic assessment including pupillary response and Glasgow Coma Scale calculation.
- 5Remove all clothing to inspect for hidden injuries and immediately apply warm blankets.
Answer
The correct sequence strictly follows the ATLS primary survey: Airway (item 1), Breathing (item 2), Circulation (item 3), Disability (item 4), and Exposure (item 5).
The Advanced Trauma Life Support (ATLS) algorithm dictates a standardized, prioritized approach to the trauma patient to address the most immediately life-threatening conditions first. This is universally remembered by the ABCDE mnemonic: Airway (with C-spine protection), Breathing, Circulation, Disability, and Exposure. Regardless of how unstable the blood pressure is (Circulation), the airway must always be addressed first.
Step-by-Step Solution
Key Concept
Advanced Trauma Life Support (ATLS) Primary Survey (ABCDE algorithm)