The name of the game in trauma cases is ALGORITHM. And yet, they're often-- especially during the dirty, bleeding, screaming ones-- CHAOTIC.
Interns and Resus residents especially, you have your ABC's memorized so let's talk about adjuncts-- or other important things to keep in mind- in order to optimize patient care in the chaos. Here are a smattering of pointers.
Airway: If you think you might intubate, NEURO exam before the meds (brief: pupils, movement of all extremities and response to pain). This should take maybe 30 seconds. Do it while someone's drawing up your meds and while you position the patient for intubation.
Breathing: While listening to the lungs, FEEL for crepitus and instability and LOOK for skin changes. We skip this sometimes though it may reveal important information about impending airway compromise.
Circulation: Recognize that occult SHOCK in a young person (with normally low resting HR) or old person (on beta-blocker or with normally elevated BP) might be missed if you don't take normal physiology into account.
**Also keep in mind that different shock types necessitate different physiologic GOALS (ie. neurogenic shock should have a higher MAP target than hemorrhagic).
Disability: REPEAT exam if signs of intoxication.
**Also, OLD PEOPLE have fragile spines so have high suspicion of central cord syndrome in the elderly even if relatively minor, low-impact trauma.
Exposure/Pelvis (if you haven't already done it): If you push on the pelvis and you feel movement, stop yourself from recoiling and DO NOT LET GO until it's wrapped up safely.
FAST: Add a quick 2-view CHEST ultrasound on to your FAST in anyone with SOB even if you think it's anxiety; the sensitivity for pneumothoraces on POCUS is higher than supine CXR and pneumothoraces may certainly be life threatening.
Glucose: Just don't forget it or to treat it if it's low. Also, high sugar in sick people is bad: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5038612/