ABCDE
Primary Survey — Trauma & ACLS
Work top-down — airway kills first.
What this mnemonic does is force a strict order of operations when the patient is unstable and you have seconds, not minutes. ABCDE — Airway with cervical spine, Breathing and ventilation, Circulation with hemorrhage control, Disability (neuro and glucose), Exposure with environment control — runs the same way in trauma, code blue, and any rapid response. Skip a step and you miss the thing that kills first. AANP boards rarely ask the acronym in isolation; they bury it inside vignettes where the right answer is whatever ABCDE tells you to do before anything else.
- AAirwayPatent? Protected? In trauma, maintain c-spine stabilization.
- BBreathingRespiratory rate, effort, breath sounds, SpO₂. Is the patient moving air?
- CCirculationPulse, blood pressure, capillary refill. Stop external hemorrhage.
- DDisabilityNeuro status — GCS, pupils, gross motor. Check glucose.
- EExposure / EnvironmentFully expose to find injuries, then warm — hypothermia worsens coagulopathy.
Clinical Context
The order reflects lethality: a blocked airway kills in minutes, massive hemorrhage in tens of minutes, hypothermia in hours. Always reassess ABC before advancing after any intervention — "finger sweep before chest thrust" in arrest.
In trauma, "D" includes glucose (hypoglycemia mimics TBI) and "E" reminds you to roll the patient and check the back — missed posterior injuries are a classic board trap. In ACLS the rhythm check and compressions sit under C; D and E get abbreviated.
Related Mnemonics
Sources
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