First priority in trauma patient according to primary survey is:?

AIIMS Delhi NO- 2019

Medical & Surgical Nursing

Easy

Appeared in: AIIMS Delhi NO- 2019

Explanation

The primary survey in trauma follows the ABCDE mnemonic to prioritize care for life-threatening injuries.
A for Airway with cervical spine (C-spine) protection is the absolute first priority.
An obstructed airway can lead to death more rapidly than issues with breathing or circulation.
In trauma, it is crucial to assume a cervical spine injury and immobilize the neck while managing the airway.
The preferred method to open the airway in a suspected C-spine injury is the jaw-thrust maneuver, not the head-tilt-chin-lift.

Option A: Circulation is the third priority ('C') in the ABCDE sequence, addressed after Airway ('A') and Breathing ('B').
Option C: Disability is the fourth priority ('D') in the ABCDE sequence. Assessing neurological status is important but must wait until life-sustaining functions (airway, breathing, circulation) are stabilized.
Option D: Exposure is the fifth and final step ('E') of the primary survey. It is performed after all other immediate life threats are addressed.

Clinical Relevance

Nursing practice connection: Prioritize focused assessment, early escalation, and real-time monitoring when managing Prioritization of care in a trauma patient using the primary survey (ABCDE) approach in acute care settings.
The ABCDE approach is a foundational, life-saving skill for any nurse working in emergency, critical care, or trauma settings. It provides a universal language and systematic process for managing critically ill patients.
In a real emergency, a nurse's ability to rapidly and accurately follow the ABCDE sequence can directly impact patient survival and outcome.
What if? If the patient was an infant with no signs of trauma who stopped breathing, the priority might shift. While airway is still critical, the underlying cause is more likely respiratory, and the emphasis would be on the A & B of the ABCDEs, without the same level of concern for C-spine injury as in a trauma case.

How to Approach the Question

First, identify the core of the question. It asks for the 'first priority' in a 'trauma patient' during the 'primary survey'.
Recall the standard protocol for initial trauma assessment. This is the ABCDE mnemonic.
List out the components of the ABCDE mnemonic: A = Airway (with C-spine control), B = Breathing, C = Circulation, D = Disability, E = Exposure.
The question asks for the 'first' priority, which corresponds to the 'A' in the mnemonic.
Evaluate the given options against the ABCDE sequence.
Option 'Airway with cervical spine control' directly matches 'A'. The other options (Circulation, Disability, Exposure) correspond to C, D, and E, which come later in the sequence. Therefore, 'Airway' is the correct first priority.

Concept Tested & Keywords

Concept Tested: Prioritization of care in a trauma patient using the primary survey (ABCDE) approach.
Stem keywords: trauma patient, primary survey, first priority
Lead-in keywords: first priority
Negative lead-in flag: false

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E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 616-618

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