Key messages

• The systematic approach to assessment includes (1) triage, (2) primary survey (ABCs), (3) resuscitation, and (4) secondary survey (head to toe).

• During the initial evaluation, the highest priority is the patency of the airway. With blunt trauma, the cervical spine should be stabilized, particularly during securing of the airway.

• Hemorrhage is the major preventable cause of trauma deaths in the hospital. Hypotension following injury should be considered to be due to hypovolemia until proven otherwise.

• The adequacy of resuscitation is assessed by continued monitoring of blood pressure, pulse pressure, pulse rate, ventilatory rate, urine output, arterial blood gases, and core temperature.

• The secondary survey does not begin until the primary survey is completed and adequate resuscitation has been initiated. All areas of the body are completely examined. Indicated radiography and special procedures, such as peritoneal lavage, can be performed during this time.

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