Abstract
The stepwise Airway Breathing Circulation (ABC) assessment and intervention during the initial evaluation of a trauma patient became dogma with the worldwide adoption of Advanced Trauma Life Support training (ATLS). This systemic and stepwise manner of assessing a trauma patient has no doubt saved countless lives by taking a prioritized approach to identifying and treating immediately life-threatening pathology. However, to date, there is little evidence that supports the concept of prioritizing “A” (airway) assessments and interventions over those of “C” (circulation and control of hemorrhage), specifically in a hypotensive or hypovolemic trauma patient. Starting with the lessons learned through military conflicts of the past two decades and now multiple trauma centers across the world, there has been a culture shift toward prioritizing “C” interventions first in patients with proven or suspected major life-threatening hemorrhage in order to optimize outcomes and avoid preventable deaths.
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Ruggero, J.M., Martin, M.J. (2022). Difficult Decisions in Trauma: Is ABC the Right Mantra?. In: Wilson, K., Rogers, S.O. (eds) Difficult Decisions in Trauma Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-030-81667-4_1
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