In the trauma primary survey, what does 'D' involve?

• A. full set of vital signs and family presence
• B. exposure and environmental control
• C. disability
• D. airway management

Answer: (B)

Disability refers to the quick neurologic check you perform during the primary survey. After ensuring the airway, breathing, and circulation, you rapidly assess brain function and potential spinal injury. Use a brief scale like the Glasgow Coma Scale or the AVPU approach to gauge consciousness and orientation. Check pupils for size and reactivity, and assess motor function and strength in the limbs by asking the patient to move or by assessing responses to commands. Look for focal neurologic deficits or asymmetry that might indicate a head injury or spinal injury. This snapshot helps you identify patients who may need airway protection, urgent neuroimaging, or neurosurgical input, and it guides ongoing monitoring. Keep cervical spine immobilization in place during this assessment because neurologic status can be affected by spinal injury. The step that follows focuses on exposure and environmental control—fully exposing the patient to inspect for hidden injuries and preventing hypothermia—not on the neurologic assessment.