Red flags
- GCS ≤8, SBP <90, RR <10/>30
- Penetrating torso injury, flail chest
First steps
- <C>ABCDE: catastrophic haemorrhage control first
- Cervical spine immobilization
- 2 large-bore IV, group-specific blood
Key investigations
- FAST scan
- CXR, pelvis XR
- CT trauma series if stable
Differentials
- Haemothorax/pneumothorax
- Intra-abdominal bleed
- Pelvic fracture
- TBI
Initial management
- Damage-control resuscitation, balanced 1:1:1 if massive transfusion
- Tranexamic acid 1 g within 3 h
- Pelvic binder, splints, analgesia
- Tetanus, antibiotics for open wounds
Referral
- Trauma surgery, Orthopedics, Neurosurgery
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