Question

In the modern trauma resuscitation protocol used for a patient with exsanguinating external hemorrhage, what is the correct order of priorities?

• A. Catastrophic hemorrhage control to Airway to Breathing to Circulation to Disability to Exposure (C-ABCDE)
• B. Airway to Breathing to Circulation to Disability to Exposure (ABCDE)
• C. Circulation to Airway to Breathing to Disability to Exposure (CABDE)
• D. Disability to Airway to Breathing to Circulation to Exposure

Hint:

Massive external bleeding is addressed even before the airway: 'C'-ABCDE.

Answer 1

The Correct Option is A

Step 1: Recall classic ATLS. The traditional ATLS primary survey follows A-B-C-D-E (Airway, Breathing, Circulation, Disability, Exposure).

Step 2: Apply the trauma/military modification. When there is catastrophic (exsanguinating) external hemorrhage, the patient can bleed to death before the airway is even secured. Therefore a preceding "C" for Catastrophic hemorrhage control is added in front, giving the <C>ABCDE sequence: control major bleeding first (direct pressure, tourniquet, haemostatic dressing), then proceed Airway to Breathing to Circulation to Disability to Exposure.

Step 3: Choose the option. The correct order is therefore Catastrophic hemorrhage control to Airway to Breathing to Circulation to Disability to Exposure (C-ABCDE). The recall key labels this as the "C-A-B-C-D-E" sequence.

Step 4: Eliminate the others. Plain ABCDE omits the life-saving first step of arresting massive bleeding. Reordering to Circulation-first without specific haemorrhage control, or Disability-first, does not reflect the catastrophic-haemorrhage protocol.

Key fact: With life-threatening external bleeding, follow <C>ABCDE - Catastrophic hemorrhage control comes before Airway.