What is the recommended order of operations for field trauma assessment using the ABCDE approach?

• A. Airway with cervical spine protection, Breathing, Circulation, Disability, Exposure
• B. Airway, Circulation, Breathing, Disability, Exposure
• C. Breathing, Airway, Circulation, Disability, Exposure
• D. Exposure, Airway, Breathing, Circulation, Disability

Answer: (A)

Securing the airway with cervical spine protection comes first because a blocked or compromised airway will doom the patient regardless of other findings, and protecting the spine during airway maneuvers prevents worsening a potential spinal injury. Once the airway is patent and stabilized, you assess and manage breathing to ensure effective ventilation and oxygen delivery, addressing chest movement, breath sounds, rate, and the need for supplemental oxygen or ventilation support. Only after breathing is stabilized do you turn to circulation to control major bleeding, assess perfusion (pulse, skin signs, capillary refill), and treat signs of shock. Next, evaluate disability to quickly determine neurologic status and level of consciousness, which helps guide priorities and prognosis. Finally, you expose the patient to inspect for hidden injuries while taking care to prevent hypothermia, ensuring no injury is missed. This order targets the most immediate threats first and protects the patient’s spine during airway management.