PolytraumaRefer

• Tranexamic acid (bleeding, within 3 h), Ringer lactate / Normal saline, Morphine, Oxygen, Td

• Primary survey: xABCDE — stop catastrophic bleeding first (pressure, tourniquet, pelvic binder), then airway with neck protection; FAST scan (ATLS 11 2025)

Primary survey and resuscitation come first; imaging follows stabilisation.

First visit

• eFAST ultrasound — Free fluid in abdomen, haemothorax, pneumothorax, tamponade.
• Chest and pelvis X-ray — In the resuscitation bay.
• Blood group and crossmatch, CBC, blood gas with lactate — Bleeding and shock.
• Capillary blood glucose — Low GCS.

Only if indicated

• CT head, cervical spine, chest, abdomen and pelvis — Haemodynamically stable patient with significant mechanism.
• PT/INR, fibrinogen — Major bleeding or on anticoagulants.
• Urine pregnancy test — Women of child-bearing age.

Follow-up and monitoring

• Haemoglobin, lactate, urine output — Repeat during resuscitation.