Airway

Orotracheal intubation is the preferred method of securing an airway.

If the case describes trauma with cervical spine injury, orotracheal intubation can still be performed with manual cervical immobilization. The best answer is the use of a fexible bronchoscope.

If the case describes extensive facial trauma and bleeding into the airway (listen for gurgling sounds), cricothyroidotomy is the best answer. Percutaneous tracheostomy is also acceptable.

Breathing

get ABG

determine likely causes of hypoxia

Circulation

In hospital setting with acute hemorrhagic shock, femoral venous line is better (more reliable, capability to administer fluid faster, rapid insertion) than peripheral lines.

Crush Injuries

rhabdomyelysis can happen even when one is unconscious

an in crush syndrome there is myoglobunaria and renal failure

Treatment for rhabdomyolysis involves intravenous saline infusions to maintain a high urine output and alkalization of urine with a target pH of 7-8 to prevent myoglobin deposition.

Blunt abdominal trauma

Pt. may have shoulder pain as a referred pain due to peritoneal irritation (Kehr sign) -share C3-C5 phrenic nerve in diaphragm and shoulder region

may also have hiccups, nausea