What should be assessed immediately in a spinal injury after establishing airway patency?

After establishing airway patency in a patient with a spinal injury, the immediate focus should be on assessing vital signs, specifically breathing effort and circulation status, as these are critical components of the primary assessment in trauma care.

In spinal injuries, there is a risk of respiratory compromise due to potential paralysis of the respiratory muscles, especially if the injury is at a cervical level. Additionally, assessing circulation status is crucial, as spinal injuries can lead to neurogenic shock, which affects blood pressure and heart rate. Evaluating breathing effort will help determine if the patient requires supplemental oxygen or airway support beyond what has already been established.

Other assessments, such as evaluating the level of consciousness, distal pulses, motor function, and the presence of bleeding, are essential but can follow the immediate assessment of breathing and circulation. The priority is always given to ensuring that the patient is stable in these two critical areas, as they directly affect survival in the trauma setting.