At any stage:

• If the patient loses consciousness and there are no signs of life on assessment, put out a crash call and commence CPR
• Make sure to reassess after any intervention

C-spine

NEXUS criteria

• Used to clear the C spine in minor trauma (impossible to clear C spine without CT in major trauma)
• There is no posterior midline cervical tenderness
• There is no evidence of intoxication
• The patient is alert and oriented to person, place, time and event
• There is no focal neurological deficit
• There are no painful distracting injuries

Airway

Clinical assessment

• If the patient can talk, their airway is patent and you can move onto the assessment of breathing
• If the patient can’t talk:
  • Look for signs of airway compromise - includes cyanosis, see-saw breathing, use of accessory muscles, diminished breath sounds and added sounds
  • Open the mouth and inspect: look for anything obstructing the airway

Causes of airway compromise

Include:

• Inhaled foreign body: symptoms may include sudden onset shortness of breath and stridor
• Blood in the airway: causes include epistaxis, haematemesis and trauma
• Vomit/secretions in the airway: causes include alcohol intoxication, head trauma and dysphagia