What is the correct order of assessment in the chief complaint of an acute injury?

What is the correct order of assessment in the chief complaint of an acute injury?

• A. Primary survey to address life threats, then history and mechanism; secondary survey (vital signs, systems review), followed by focused exam and plan
• B. History and mechanism first
• C. Secondary survey first
• D. Focused exam before primary survey

Answer: (A)

In an acute injury, safety and life-saving care come first. Start with the primary survey to address life threats—airway, breathing, circulation, disability, and exposure. Only after those threats are stabilized do you gather the patient’s history and mechanism of injury to inform the evaluation and plan. Next, you perform a secondary survey that includes vital signs and a systems review to uncover injuries not immediately life-threatening. Finally, you carry out a focused exam directed at suspected injuries and establish the plan for treatment and monitoring. This order protects the patient and guides efficient, thorough care, which is why this sequence is the best choice. Starting with history and mechanism would delay essential life-saving actions. A secondary survey before ensuring life threats are managed could miss critical problems. A focused exam before completing the primary survey risks overlooking urgent issues.

In an acute injury, safety and life-saving care come first. Start with the primary survey to address life threats—airway, breathing, circulation, disability, and exposure. Only after those threats are stabilized do you gather the patient’s history and mechanism of injury to inform the evaluation and plan. Next, you perform a secondary survey that includes vital signs and a systems review to uncover injuries not immediately life-threatening. Finally, you carry out a focused exam directed at suspected injuries and establish the plan for treatment and monitoring. This order protects the patient and guides efficient, thorough care, which is why this sequence is the best choice.

Starting with history and mechanism would delay essential life-saving actions. A secondary survey before ensuring life threats are managed could miss critical problems. A focused exam before completing the primary survey risks overlooking urgent issues.