The Haemorrhage, Airway, Breathing, Circulation, Disability, Exposure/Environmental control approach to individual patient management in trauma is well established and embedded in numerous training courses worldwide. Further improvements in trauma outcomes are likely to result from a combination of system-level interventions in prevention and quality improvement, and from a sophisticated approach to clinical innovation.
At the level of an individual patient, protocols for investigating and treating patients after severe physical trauma are beguilingly straightforward: stop major haemorrhage, open the airway while protecting the cervical spine, ensure adequate breathing, maintain an adequate circulation, assess disability and act to reduce further neurological damage, and expose the patient to identify all injuries while paying attention to environmental temperature so as not to worsen hypothermia.