Airway
Speaking?
Breathing
Inspection
Palpation
Auscultation
Circulation
BP, HR, Pulse pressure
Physical exam
External bleeding?
Disability
Neurologic exam
GCS
Exposure
Complete exposure
Rectal exam
Avoid hypothermia
Adjuncts
FAST, X-rays, labs,
NG, Foley
Vital signs normalizing
no no
Protecting airway?
Shock?
GCS >8?
Chin lift / jaw thrust
Definitive airway
- orotracheal intubation
- cricothyroidotomy
Supplemental O2
IV access
Bolus
Immobolize C-spine
CT head
Neurosurgical consult
Mannitol / hyperventilate?
Secondary Survey
AMPLE history
Head to toe physical exam
Complete neurologic exam
Consider transfer to higher level of care