Priorities and diagnostic studies in the management of the injured patient

The traumatized patient is best served by an orderly and sequential resuscitation and evaluation. Primary priorities include the establishment of a secure airway, adequate ventilation and hemodynamic status. These considerations should be followed by a brief history, systemic physical examination and radiographic studies. Studies utilized in blunt trauma include diagnostic peritoneal lavage and computed tomography. Nuclear magnetic resonance and ultrasound may prove useful in the future. In penetrating trauma, traversing missiles mandate surgical exploration. Stab wounds may be managed by several alternative methods. Emergency thoracotomy has a limited role in the blunt trauma patient but may be life saving in those suffering penetrating trauma.