Trauma Assessment & Management

Trauma questions are scenario-heavy: the exam wants to know if you can prioritize a bleeding, hypoxic, altered patient in under 60 seconds.

EMT · AEMT · Paramedic

The primary survey

Airway with C-spine, breathing, circulation with hemorrhage control, disability, exposure. Massive hemorrhage often moves ahead of airway (MARCH: Massive hemorrhage, Airway, Respiration, Circulation, Head/Hypothermia).

Hemorrhage control

Direct pressure first. If uncontrolled extremity bleeding, tourniquet 2–3 inches proximal to the wound, high and tight, time-stamped. Junctional hemorrhage: pressure and hemostatic gauze.

Spinal motion restriction

Modern protocols use selective SMR — mechanism plus clinical criteria (altered, intoxicated, midline tenderness, distracting injury, neuro deficit). Long boards are extrication tools, not transport devices, in most systems.

Frequently asked

What is permissive hypotension?
Titrating fluids to maintain a systolic BP around 80–90 mmHg (or a palpable radial pulse) in bleeding trauma patients, to avoid dislodging clots. It's paramedic-scope in most systems.

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