1 Trauma Assessment and Triage
Learn how triage, the xABCDE primary survey, further examination, reassessment, and team communication work together in trauma care.
The structure of trauma assessment
Trauma assessment is a rapid, structured process: identify and treat immediate threats, then look for additional injuries and repeat the assessment as the patient's condition changes. Follow local protocols and the limits of your scope of practice.
The assessment proceeds from and the primary survey to further examination when appropriate, with continuing throughout care. Urgent findings should be addressed as they are discovered.
and urgency
sorts patients by urgency to identify those who need immediate intervention. It is not a diagnosis and does not replace repeated clinical assessment.
Priorities may change as a patient's condition or available resources change. During mass-casualty situations, follows the applicable incident plan and resource context.
The
The rapidly identifies and addresses immediate threats to life. In the current American College of Surgeons Advanced Trauma Life Support (ATLS) approach, its steps are:
x — Control life-threatening external hemorrhage.
A — Assess airway with cervical-spine protection.
B — Assess breathing.
C — Assess circulation.
D — Assess disability with a brief neurologic assessment.
E — Assess exposure and environmental control.
Treat urgent problems as they are found. The sequence guides priorities; it is not a reason to delay intervention until every step is complete.
The
The is a systematic head-to-toe examination and history for identifying additional injuries. Begin it after immediate life threats identified during the primary survey have been addressed and the patient is sufficiently stabilized for further examination.
The should not precede treatment of immediate threats. If a new life-threatening problem appears, address it rather than continuing the examination.
and changing conditions
continues throughout trauma care because a patient's status can change rapidly. After an intervention for an abnormal finding, reassess the patient and the response to the intervention, including relevant observations and vital signs. Communicate important changes and continue the assessment as appropriate.
If the patient deteriorates or a new concern arises, repeat the primary survey to identify and address current threats. For example, if a patient becomes increasingly confused and less responsive during the , pause that examination and return to the primary survey rather than assuming the earlier findings still apply.
Timely communication of significant findings, interventions, and results helps the team coordinate parallel tasks, understand the patient's current status, avoid missed or duplicated actions, and respond to changes as care proceeds.