By CRUX OF SURGERY — 09 Feb 2026 GENERAL ATLS Ensure the patient is managed in the resuscitation bay and that a trauma call has been put out Immediately perform a rapid primary survey in an A to E manner with simultaneous resusctiation following the ATLS protocol Prescribe adequate analgesia using the WHO pain ladder Airway Maintenance with Restriction of Cervical Spine Motion Apply 15L oxygen through a non-rebreather mask Ensure triple immobilisation of the cervical spine Assess airway patency, checking for foreign bodies, or signs of head and neck fractures Breathing and Ventilation Assess for jugular venous distention, and a central trachea Inspect, auscultate, palpate and percuss the chest Check oxygen saturations and respiratory rate ABG Chest x-ray Carbon dioxide monitoring Circulation with Haemorrhage Control Check blood pressure and heart rate Assess skin perfusion Palpate central and peripheral pulse for regularity, volume and rate Assess temperature of peripheries Examine the patient's chest, abdomen, pelvis and limbs, looking for sources of bleeding Request chest x-ray, pelvic x-ray and/or FAST scan to further investigate for thoracic, pelvic or abdominal sources of haemorrhage Insert x2 large-bore peripheral cannulas Obtain blood samples for FBC, CRP, U&Es, LFTs, beta hCG for all females of childbearing age, and group and save Obtain a venous blood gas with a lactate Initiate fluid resuscitation with warmed intravenous crystalloids If unresponsive to crystalloid therapy, they should get a blood transfusion Consider activating major haemorrhage protocol to manage coagulopathy Consider tranexamic acid Urinary catheter insertion to monitor urine output and check for haematuria Continuous electrocardiography Disability; Neurologic Evaluation Establish GCS Assess pupillary size and reaction Blood sugar level Check and monitor temperature B C Exposure and Environmental Control Completely undress the patient, usually by cutting off his or her -garments and thoroughly examine the patient Cover the patient with warm blankets or an external warming device, and maintain a warm environment Closing Statement Re-assess the patient Escalate to senior Involve other specialities such as anaesthetics or gastroenterology Prepare for theatre: Make the patient NBM, inform the anaesthetist and theatre co-ordinator, prepare a consent form