A sense of priority is required when dealing with severe multiple injuries, and it should first be clear which conditions may endanger the patient’s life. The first step should be to confirm the presence of the following: airway obstruction 1. chest injury with respiratory distress; 2. severe external or internal bleeding. Abdominal injuries If there are multiple patients at the same time, the order in which they receive treatment should be determined by severity. This depends on the quality of the medical staff and the condition of the medical equipment. If conditions and time permit, the patient should be monitored with equipment as early as possible. The ideal monitoring facilities include: electrocardiogram, blood pressure, fingertip oxygen saturation, and facilities for monitoring CO2. The basic steps in trauma care include: (1) airway; (2) respiration; (3) circulation; (4) assessment of the degree of nerve damage; and (5) whole body examination. The initial examination should take no more than 2 to 5 minutes. When multiple life-threatening conditions are present, they should be addressed simultaneously, including: Airway management Assess the airway. Can the casualty speak and is he or she struggling to breathe? If airway obstruction is present, the following steps should be considered: 1. chin lift/jaw rest (tongue attached to mandible); 2. removal of foreign body or secretions (if present); 3. placement of an oropharyngeal or nasopharyngeal airway; 4. endotracheal intubation, care should be taken to maintain the neck in midline position. Respiratory management Respiratory management should again assess whether the airway is patent and breathing is normal. If abnormal, the following steps should be considered: 1. drainage and decompression of tension pneumothorax and hemothorax; 2. closure of open chest trauma; 3. manual assisted ventilation; 4. adequate oxygenation if available; 5. if the patient is unstable, the ABC steps of resuscitation must be repeated. Circulatory management Circulatory management should be implemented by re-checking the oxygen supply, airway and respiration. If the circulation is not normal, the following steps should be considered: 1. stop bleeding; 2. establish 2 intravenous accesses (14G or 16G needle) if possible; 3. administer fluids. Assess the degree of neurological damage Make a rapid neurological assessment: whether there is a response to call, whether there is a verbal response to pain, and whether there is confusion. If it is too late to do the Glasgow Consciousness Scale, use the AVPU system of insight: A (awake): awake, V (verbal response): verbal response or not, P (painful response): response or not to painful stimuli, U (unresponsive): no response. Whole-body examination Remove the patient’s entire body and look for areas of damage. Braking is particularly important if a neck or spinal injury is considered.