EM Cases · Primary survey
Blunt polytrauma primary survey — <C>ABCDE resus station
ACEM Fellowship OSCE resus station testing catastrophic haemorrhage control before airway, tension/breathing threats, damage-control circulation with TXA, and iterative primary survey discipline.
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Study tools
Target exams
ACEMFRCEMABEMFRCPCCCFPEMEBEEM
Prompt
A 35-year-old motorcyclist with external thigh haemorrhage, respiratory distress, and hypotension arrives as a trauma call.
Station brief
Format. Clinical-management (resus) station, 11 minutes. You are the trauma team leader.
[1]Candidate instructions. Run the primary survey from end-of-trolley handover. Treat life threats in order. Examiner plays the team.
[1]References5ShowHide
- [1]Polmear MM, Kakalecik J, Croft C, et al. Early care of polytraumatized patients: a framework for orthopaedic surgeons. Journal of the American Academy of Orthopaedic Surgeons, 2025.PMID 39739953
- [2]Rossaint R, Afshari A, Bouillon B, et al. The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition. Crit Care, 2023.PMID 36859355
- [3]Scerbo MH, Holcomb JB, Taub E, et al. The trauma center is too late: Major limb trauma without a pre-hospital tourniquet has increased death from hemorrhagic shock. J Trauma Acute Care Surg, 2017.PMID 29190257
- [4]Shakur H, Roberts I, Bautista R, et al. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet, 2010.PMID 20554319
- [5]Kragh JF Jr, Walters TJ, Baer DG, et al. Survival with emergency tourniquet use to stop bleeding in major limb trauma. Ann Surg, 2009.PMID 19106667