Trauma management begins with a primary survey, normally referred to as Advanced Trauma Life Support (ATLS). Advanced Trauma Life Support (ATLS) consist of 5 steps, also known as the ABCDE approach, which include:

1. Airway assessment and the stabilisation of the cervical spine:
   An emergency medicine physician at North Coast Emergency Group will assess the airway for any signs of airway obstruction or respiratory distress. The patient's mouth and larynx will also be assessed for injury or obstruction. The main goal for these assessments is to maintain a patent airway through which the patient can be successfully oxygenated. The cervical spine will be protected with the use of manual in-line stabilisation, followed by a gentle application of a properly fitted hard collar.
2. Breathing:
   The physician will assess the patient's oxygenation status using pulse oximetry and examine the chest wall for any signs of injury, including absent breath sounds and asymmetric or paradoxical movement. In unstable patients, a chest drain will be inserted for a massive haemothorax (accumulation of blood within the pleural cavity) and a flail chest (when a segment of the rib cage breaks and becomes detached from the rest of the cavity).
3. Circulation and haemorrhage control:
   The patient's pulse rate, skin colour, capillary refill time and blood pressure will be assessed. The physician will also assess the patient for any other effects of inadequate circulation, including an increased respiratory rate and a decreased mental state. Potential bleeding sites such as the pelvic region, abdomen, and femur will also be assessed for any bleeding.
4. Disability and neurological evaluation:
   The patient's Glasgow Coma Scale (GCS) score will be assessed. The GCS is a scale that's used for assessing a patient's neurological status, consciousness and degree of brain injury. If the GSC score is above 8, a tube will be inserted through the mouth or nose and placed in the trachea to help maintain a patent airway. The eye's pupillary size, motor function and light touch sensation will be assessed.
5. Exposure and environmental control:
   The patient's body will be examined for any signs of occult injury, and if the patient is hypothermic (when the body loses heat faster than normal), he/she will be covered with warm blankets, and warm intravenous fluids will be administered. The physician will also palpate the patient for vertebral tenderness or rectal tone.