Which of the following steps is/are part of the primary survey in a trauma patient?

a. Insuring adequate ventilatory support

b. Measurement of blood pressure and pulse

c. Neurologic evaluation with the Glasgow Coma Scale

The resuscitation team’s first priority is to simultaneously assess the airway, blood pressure and level of consciousness of the patient. The first priority is assessment of the airway. After establishment of an airway, the next priority is to insure adequate ventilatory exchange by rapid auscultation of both lung fields and assessment for mechanical factors that may interfere with breathing. After establishment of an airway, ventilation and appropriate pleural drainage, if necessary, the next priority is the assessment of the patient’s circulatory status. This includes an estimation of blood volume and cardiac function. The initial survey evaluates blood pressure, pulse, and skin perfusion. It is important to emphasize that effective resuscitation from hemorrhagic shock requires both restoration of intravascular volume and control of hemorrhage. The final priority of the primary survey is a brief neurological evaluation using the components of the Glasgow Coma Scale. Although maintaining axial immobilization of the cervical spine is an important early component of all assessments and resuscitation protocols, examination of the cervical spine regardless of injury is part of the secondary survey.