In a patient with multisystem trauma, what is the best sequence of care during transport?

In a patient with multisystem trauma, what is the best sequence of care during transport?

• A. Primary survey, secondary survey, C-spine assessment, rest of care during transport
• B. Primary survey, C-spine assessment, secondary survey, rest of care during transport
• C. Secondary survey, primary survey, C-spine, transport
• D. Primary survey, rest of care, C-spine, transport

Answer: (B)

The main idea is to address life threats first, then protect the spine, followed by a thorough head-to-toe assessment, and finally continue care during transport. In multisystem trauma, you start with the primary survey to identify and treat immediate dangers to life (airway, breathing, circulation). If spinal injury is suspected, cervical spine precautions are established early and the C-spine is assessed as part of that initial phase, not after finishing a full secondary check. Once the primary survey and spinal precautions are done, you move on to the secondary survey to document all injuries and refine treatment, then keep providing ongoing care and monitoring during transport. This order prevents delaying spinal protection and ensures life-threatening issues are handled promptly. Delaying C-spine assessment until after the secondary survey risks moving a potentially unstable spine. Starting with secondary before primary neglects immediate life threats. Delaying C-spine in favor of vague “rest of care” steps can postpone essential immobilization and safety during transport.

The main idea is to address life threats first, then protect the spine, followed by a thorough head-to-toe assessment, and finally continue care during transport. In multisystem trauma, you start with the primary survey to identify and treat immediate dangers to life (airway, breathing, circulation). If spinal injury is suspected, cervical spine precautions are established early and the C-spine is assessed as part of that initial phase, not after finishing a full secondary check. Once the primary survey and spinal precautions are done, you move on to the secondary survey to document all injuries and refine treatment, then keep providing ongoing care and monitoring during transport.

This order prevents delaying spinal protection and ensures life-threatening issues are handled promptly. Delaying C-spine assessment until after the secondary survey risks moving a potentially unstable spine. Starting with secondary before primary neglects immediate life threats. Delaying C-spine in favor of vague “rest of care” steps can postpone essential immobilization and safety during transport.