In the field trauma primary survey, which element comes next after addressing airway and breathing?

• A. Disability
• B. Circulation
• C. Exposure
• D. Environmental control

Answer: (B)

In the field trauma primary survey, the focus after addressing airway and breathing is Circulation. The priority here is to ensure adequate perfusion and quickly control any life-threatening bleeding. You assess for signs of shock, look for obvious external bleeding, and take immediate steps to stop it—direct pressure for wounds, tourniquets if needed, and rapid initiation of IV or IO access for fluids as protocol allows. This step is critical because tissues cannot be oxygenated or perfused without a functioning circulation, so addressing perfusion takes precedence before evaluating neurological status or inspecting the rest of the body.

Disability, the neurologic assessment, comes after Circulation to gauge CNS status once perfusion is stabilized, and Exposure follows to thoroughly inspect the patient for injuries, with environmental control applied to prevent hypothermia.