Trauma: Primary Survey (xABCDE)

• Run the primary survey xABCDE per ATLS 11th, controlling catastrophic bleeding first while resuscitating simultaneously; activate massive transfusion early and give TXA <3 h — TXA given >3 h after injury increases mortality, so never give it late.
• eFAST plus chest/pelvis X-ray in the bay; CT pan-scan once stable.
• Accept permissive hypotension (SBP 80–90) until hemorrhage is controlled, EXCEPT in TBI where SBP stays ≥100–110.
• Damage-control surgery stops bleeding/contamination; ICU resuscitation, definitive repair later.
• REBOA is an ATLS 11th option for non-compressible torso hemorrhage; low-titer group O whole blood is increasingly preferred where available.

Major trauma

First tests: Full blood count, Blood group and crossmatch, PT/INR, aPTT and fibrinogen, Blood lactate, Ionized calcium.

Only if indicated: eFAST / emergency bedside imaging, Trauma CT according to injury/stability, Pregnancy test.

Repeat monitoring: PT/INR, aPTT and fibrinogen, Blood lactate.

Major burns

First tests: Burn extent, depth and associated-injury assessment, Full blood count, Sodium, potassium, bicarbonate, urea and creatinine, Urine output and fluid balance.

Only if indicated: Blood gas with co-oximetry, Blood lactate, 12-lead ECG, Creatine kinase.

Repeat monitoring: Sodium, potassium, bicarbonate, urea and creatinine.

Deteriorating postoperative patient

First tests: Immediate clinical and surgical review, Blood glucose, Full blood count, Sodium, potassium, bicarbonate, urea and creatinine, 12-lead ECG.

Only if indicated: Blood lactate, Blood group and crossmatch, Source-directed cultures, Complication-directed bedside imaging / CT.

Repeat monitoring: Frequent physiological and organ-function reassessment.

• Pelvic Ring Injury Management
• Cervical Spine Evaluation in Trauma Patients
• Major Burns: The First 24 Hours
• The Deteriorating Postoperative Patient