Blunt trauma: primary survey, catastrophic haemorrhage and tension pneumothorax

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Educational simulation. Not for real patient care and not a substitute for supervised training. Always follow local protocols.

What you will practise

Prioritise life threats using the ATLS-style structured approach, treating catastrophic external haemorrhage first.
Manage the airway with manual in-line cervical spine stabilisation.
Recognise tension pneumothorax as a clinical diagnosis and decompress without waiting for imaging.
Apply principles of haemorrhagic shock resuscitation, including early blood products and avoiding excess crystalloid.
Complete disability and exposure assessment and prevent hypothermia.
Re-evaluate after interventions and defer imaging until the patient is stable enough.

In the midaxillary line, the inferior limit of the parietal pleura lies at which rib?
After a road traffic collision, a man has severe dyspnoea, BP 75/40 mmHg, distended neck veins, absent breath sounds on the right and tracheal deviation to the left. What is the immediate management?
A man arrives after a stabbing with a heavily bleeding limb wound, a patent airway and normal breathing, pulse 130 and BP 80/50 mmHg. In the trauma primary survey, what is the first action?
After a road traffic collision, a man is confused with a pulse of 130/min, respiratory rate 34/min, low systolic blood pressure and reduced urine output. According to the ATLS classification of haemorrhage, which class best fits this picture?