MVA

If a patient who has met MVA (motor-vehicle accident) is brought to you, what is the first thing you would do? 

A preliminary survey can be done following ABCDEF.

A: Airway

Protect cervical spine f injure.

Access airway patency, check for any obstruction.

Establish airway if there is obstruction.

B: Breathing

Check RR, bilateral chest movement, precuss and auscultate.

Consider O2, intubation, or manage according to causes, eg. tension pnuemothorax.

C: Circulation

Check PR, BP, and CRT.

If no cardiac output, do CPR.

If shock, use plasma expander or inotropes.

D: Disability

Access level of consciousness by using Glasgow Coma Scale (GCS) or AVPU score.

• A = Alert
• V = responds to Vocal stimuli
• P = responds to Pain
• U = Unresponsive

Check pupils: size, equality, light reaction.

E: Exposure

Undress patient, but cover to avoid hypothermia.

F: Find

Check for all possible trauma site

How do you apply cervical collar? 

To apply the cervical collar,

1. The assistant need to realign the cervical spine by manual stabilisation.
2. The doctor need to measure the length from the horizontal plane that goes through the chin, to the horizontal plane that goes through the shoulder or the clavicle. This is needed to adjust the size or the cervical collar.
3. If necessary cut off any cloth that inhibit the application of the cervical collar, e.g. the hood of a jacket.
4. Slip the posterior piece of the cervical collar behind the neck.
5. Apply the anterior / front piece of the cervical collar over the neck.
6. Check whether the cervical collar fits well to the jaw or whether it is too tight.

--- UPDATE ---

I want to emphasize that if an unconscious patient with MVA comes to you, a cervical collar must be applied because you are not sure whether this patient has cervical fracture or not until it is ruled out.