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Purpose of Review <p>This review evaluates the change from traditional airway-first (ABC) to circulation-first (CAB) resuscitation in unstable trauma patients. It examines recent evidence supporting this paradigm shift and underscores the importance of tailoring resuscitation strategies to individual patient needs.</p> Recent Findings <p>Hemorrhage drives approximately 90% of preventable trauma deaths, necessitating a switch from airway-first to circulation-first resuscitation. Recent retrospective data demonstrates that in certain trauma populations prioritizing hemorrhage control is associated with a nearly fourfold decrease in mortality compared to the ABC approach.</p> Summary <p>In unstable trauma patients, particularly in penetrating trauma, recent evidence favors a circulation-first approach to the resuscitation. However, given the observational nature of current data and poor generalizability to the broad unstable trauma population, care teams must prioritize flexible, patient-centered care over a rigid dogmatic approach to trauma resuscitation.</p>

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When Seconds Matter, Prioritization of Circulation Before Airway in Trauma Resuscitation

  • 期刊论文

  • 发表日期：

    2026年7月31日

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  • Lulu Fatima Gusti,
  • Colin Wakefield,
  • Kimberley Li,
  • Rajen Nathwani

摘要

Purpose of Review

This review evaluates the change from traditional airway-first (ABC) to circulation-first (CAB) resuscitation in unstable trauma patients. It examines recent evidence supporting this paradigm shift and underscores the importance of tailoring resuscitation strategies to individual patient needs.

Recent Findings

Hemorrhage drives approximately 90% of preventable trauma deaths, necessitating a switch from airway-first to circulation-first resuscitation. Recent retrospective data demonstrates that in certain trauma populations prioritizing hemorrhage control is associated with a nearly fourfold decrease in mortality compared to the ABC approach.

Summary

In unstable trauma patients, particularly in penetrating trauma, recent evidence favors a circulation-first approach to the resuscitation. However, given the observational nature of current data and poor generalizability to the broad unstable trauma population, care teams must prioritize flexible, patient-centered care over a rigid dogmatic approach to trauma resuscitation.