During the primary survey of a trauma patient using ATLS protocol, all of the following are components of the 'A' phase EXCEPT:

Question

Accepted Answer

D. Auscultation of bilateral breath sounds to rule out pneumothorax. ## Understanding the Primary Survey: 'A' Phase

### The 'A' (Airway) Component
The primary survey's 'A' phase focuses exclusively on **airway assessment and management**, with simultaneous cervical spine protection.

**Key Point:** The 'A' phase does NOT include auscultation of breath sounds — that is part of the 'B' (Breathing) phase.

### Correct Components of 'A' Phase

1. **Airway patency assessment** — look for obstruction, stridor, or pooled secretions
2. **Cervical spine immobilization** — applied immediately in all trauma patients until C-spine injury excluded
3. **Removal of foreign bodies** — blood clots, vomitus, loose teeth, dentures
4. **Definitive airway establishment** — indicated if GCS ≤8, inability to protect airway, or apnea

### Why Auscultation is NOT Part of 'A'

Auscultation of bilateral breath sounds (to detect pneumothorax, hemothorax, or absent breath sounds) is a **'B' (Breathing) phase** activity. It requires the airway to already be patent and the patient to be breathing — assessments that come after successful airway management.

**High-Yield:** The ATLS primary survey sequence is **A → B → C → D → E**. Each phase must be completed before moving to the next. Mixing components from different phases is a common exam trap.

### ATLS Primary Survey Phases

| Phase | Focus | Key Actions |
|-------|-------|-------------|
| **A** | Airway + C-spine | Patency, remove obstruction, immobilize, definitive airway if GCS ≤8 |
| **B** | Breathing | Auscultate, assess work of breathing, decompress tension pneumothorax |
| **C** | Circulation | Pulse check, hemorrhage control, IV access, fluid resuscitation |
| **D** | Disability | GCS, pupil reactivity, motor/sensory exam |
| **E** | Exposure | Remove clothing, log-roll, inspect back |

**Clinical Pearl:** In a patient with altered consciousness (GCS ≤8), airway protection takes absolute priority — intubation is indicated even if the patient is breathing spontaneously, because they cannot protect against aspiration.

Answer

A. Establishment of a definitive airway if Glasgow Coma Scale ≤8

Answer

B. Removal of foreign bodies and blood clots from the oropharynx

Answer

C. Assessment of airway patency and cervical spine immobilization

During the primary survey of a trauma patient using ATLS protocol, all of the following are components of the 'A' phase EXCEPT:

Explanation

Understanding the Primary Survey: 'A' Phase

The 'A' (Airway) Component

Correct Components of 'A' Phase

Why Auscultation is NOT Part of 'A'

ATLS Primary Survey Phases

Practice similar questions

Join our NEET PG community

Phase	Focus	Key Actions
A	Airway + C-spine	Patency, remove obstruction, immobilize, definitive airway if GCS ≤8
B	Breathing	Auscultate, assess work of breathing, decompress tension pneumothorax
C	Circulation	Pulse check, hemorrhage control, IV access, fluid resuscitation
D	Disability	GCS, pupil reactivity, motor/sensory exam
E	Exposure	Remove clothing, log-roll, inspect back