All the following are true about imaging in primary survey of a trauma patient except:
(A) Cervical X-ray is not mandatory (B) Chest X-ray and pelvic X-ray are taken as a pa of primary survey (C) Hemodynamically unstable patients should not be sent for CT scan (D) All patients should have chest X-ray-PA view only
(D) Answer- D. All patients should have chest X-ray-PA view onlyChest X-ray and X-ray pelvis are taken in AP view in the adjuncts to the primary survey of a trauma patient.The steps in the ATLS (Advanced Trauma Life Suppo):Primary survey with simultaneous resuscitation - identify and treat what is killing the patientSecondary survey - proceed to identify all other injuriesDefinitive care - develop a definitive management planABCDE of trauma care:Airway assessment and protection (maintain cervical spine stabilization when appropriate)Breathing and ventilation assessment (maintain adequate oxygenation)Circulation assessment (control hemorrhage and maintain adequate end-organ perfusion)Disability assessment (perform basic neurologic evaluation)Exposure, with environmental control (undress patient and search everywhere for possible injury, while preventing hypothermia)Adjuncts to the primary survey:Blood - FBC, urea and electrolytes, clotting screen, glucose, toxicology, cross-matchECGTwo wide-bore 18G cannulae for intravenous fluidsUrinary and gastric cathetersRadiographs of the cervical spine and chestLateral cervical spine, chest AP view, and pelvis AP view are done when necessary.Other more specialized forms of imaging, such as ultrasound, computerized tomography, angiography, and diagnostic peritoneal lavage, should be considered after the secondary survey and only when the patient is stable after initial resuscitation.