• ABCDE
• Airway maintenance with cervical spine protection
• Breathing and ventilation with life-threatening chest injury management
• Circulation with hemorrhage control
• Disability or neurologic status with intracranial mass recognition
• Exposure/environment with maintenance of normal body temp

1. Airway
2. Breathing
3. Circulation
4. Disability
5. Exposure

1. Visualize the airway.
2. Start with supplement O2 by nasal cannula or face mask for conscious patients.
3. If pt is unconscious do jaw-thrust maneuver and provide respiratory support. (can also do OP or NP airway if needed.)
4. Intubate if necessary.
5. If unable to intubate, perform surgical airway (cricothyroidectomy).
6. Maintain cervical spine stabilization/immobilization in trauma patients until spinal injury has been r/o. However, never allow this concern to delay airway management!

When does a patient need to be intubated?

When does a patient need a surgical airway?

• Patient needs to be intubated if there is:
• apnea
• signifcantly depressed mental status (GCS<8)
• impending airway compromise (ex. maxillofacial trauma or inhalation injury in fires)
• Patient needs surgical airway (cricothyroidectomy) if he cannot be intubated secondary to upper airway trauma or obstruction.

• 15 total points possible
• Eyes - 4 points possible
• Verbal - 5 points possible
• Motor - 6 points possible
• Mnemonic: 4 eyes, Jackson 5, V6 engine

• spontaneous eye movement = 4 pts
• eyes respond to command = 3 pts
• eyes respond to pain = 2 pts
• no response = 1 pt

• Oriented = 5
• Confused speech = 4
• Inappropriate words = 3
• Incomprehensible = 2
• None = 1

• hypotension
• equal breath sounds
• JVD