What is the first component of the Primary Survey in field trauma care?

• A. Airway
• B. Breathing
• C. Circulation
• D. Disability

Answer: (A)

Securing a patent airway is the first step because without a clear airway, air cannot reach the lungs regardless of how well breathing is assessed or how strong circulation is. In field trauma, airway compromise can occur quickly from the tongue falling back in an unconscious patient, facial or jaw injuries, swelling, blood, or vomitus. The goal is to open and maintain patency while protecting the spine if a cervical injury is suspected. Use a jaw-thrust or inline stabilization rather than head-tilt-chin-lift, then clear the airway with suction as needed. If the patient is unconscious and cannot protect their airway, insert an oropharyngeal airway; if the patient is conscious or has intact gag reflex with no suspected skull fracture, a nasopharyngeal airway may be considered. If airway adjuncts fail or ventilation is not adequate, proceed to advanced airway management. Once the airway is secure, you can evaluate and manage breathing.