In pediatric trauma, the first step of the primary survey is...

• A. Breathing assessment
• B. Airway assessment and stabilization
• C. Circulation assessment
• D. Disability assessment

Answer: (B)

Securing and evaluating the airway takes priority in a pediatric trauma primary survey because nothing else can be assessed or stabilized effectively without a patent airway. A clear airway ensures oxygen reaches the brain and vital organs, and children can desaturate rapidly due to a higher metabolic rate and relatively smaller airways that are easily obstructed by edema, secretions, or trauma. Immediate actions focus on assessing patency, performing maneuvers to open the airway (such as a jaw-thrust if spinal injury is possible, with careful positioning to avoid further harm), suctioning as needed, and delivering high-flow oxygen while protecting the cervical spine. Once the airway is secured or protected, you proceed to evaluate breathing, then circulation and disability.