Always assume the patient has a cervical spine injury and maintain in-line traction when performing these procedures. A patent airway does not guarantee adequate gas exchange, oxygen delivery, and carbon dioxide elimination. Ensure that the patient is adequately breathing. Inspect, percuss, and auscultate the chest. Assess the adequacy of circulation.
Shock is defined as inadequate oxygen delivery to the cells.
A quick assessment can be performed by evaluation for impaired consciousness, pale skin, and rapid or thready pulse. Hemorrhage is the most common cause of shock after trauma, and is the major cause of preventable death. Therefore, assume all hypotension is due to hemorrhage unless proven otherwise. Initially treat all shock as if it were hemorrhagic. Establish two large caliber intravenous lines.