A road accident victim — unconscious, GCS 7; intubate, CT shows subdural; neurosurgery. ATLS primary survey (A — airway with C-spine; B — breathing — tension pneumothorax — needle; C — circulation — bleeding control, fluids/blood; D — disability — GCS; E — exposure): treat as you find. Head injury (GCS — eye/verbal/motor; <8 — intubate; CT — extradural — lens-shaped, lucid interval; subdural — crescent; diffuse axonal): neurosurgery — burr holes/craniotomy. Chest (tension — tracheal shift — needle decompression; hemothorax — chest tube; flail — ventilation). Abdominal (FAST — free fluid; unstable + positive — laparotomy; stable — CT). The primary survey is the ritual — ABCDE before anything else.