In cases of multiple closed extremity fractures, what should be prioritized first?

In trauma management, particularly with multiple closed extremity fractures, ensuring adequate oxygenation and ventilation is critical and should be prioritized first. This is because the primary goal in trauma care is to stabilize the patient's overall condition before addressing individual injuries. If the patient is not adequately oxygenated or ventilated, there is a risk of systemic hypoxia, which can lead to organ dysfunction and further complicate the management of any injuries.

When managing suspected polytrauma, addressing airway, breathing, and circulation (the ABCs of trauma care) takes precedence. Initiating measures to optimize oxygenation and ventilation ensures that vital organs receive the oxygen they need to function properly, ultimately affecting the patient's prognosis and ability to tolerate further interventions.

After stabilizing oxygenation and ventilation, the focus can then shift to assessments of individual injuries and limb perfusion, which are also important in the overall management of fractures to prevent complications such as compartment syndrome or skin necrosis. Each of these subsequent steps is essential, but they come after guaranteeing the patient's oxygenation and ventilation.