A. airway assessment, management- Chin lift, Clear the airway of foreign bodies, Oral airway, Intubation, or check intact tube for placement, or Cricothyroidotomy. It is important to maintain a neutral position, with manual immobilization as necessary when establishing an airway.

Breathing- expose chest, determine rate and depth of respiration. Auscultate bilaterally. Administer O2, alleviate tension pneumothorax, seal open pneumothorax

C. Circulation- Pulse quality, rate, regularity. Color of skin, capillary refill and Identify site of hemorrhage. It is also important to establish two large bore IV's (18 or bigger) and initiate fluid resuscitation with LR or Blood (O negative). apply ECG and pulse ox monitoring.

(Insert foley and NGT -with contraindications- gross blood at meatus or clear fluid at nose.)

D. Disability- Brief neurological evaluation. Determine the level of consciousness and the reactivity of the pupils.

E. Exposure- Completely undress the patient.