What is the first step in managing a teen who has been severely injured and is actively bleeding?

In the management of a severely injured teen who is actively bleeding, the primary aim is to address life-threatening conditions, particularly airway management and breathing support. In this case, performing endotracheal intubation and ensuring appropriate ventilation is prioritized to secure the airway and maintain adequate oxygenation and ventilation. Severe injuries can lead to airway compromise due to aspiration, altered consciousness, or significant swelling, making it critical to ensure the airway is protected and properly managed.

While other interventions may be necessary in the comprehensive management of trauma, securing the airway is often the first and most urgent intervention, as inadequate oxygenation can rapidly lead to systemic collapse. Therefore, intubation may be crucial to guarantee that air can reach the lungs effectively while simultaneously managing the risk of further complications stemming from ongoing active bleeding.

Other possibilities such as obtaining imaging studies or inserting central venous lines, while important for overall management, do not directly address the immediate threat posed by potential airway obstruction or inadequate ventilation following severe trauma. Similarly, applying a pneumatic antishock garment may assist in stabilizing the circulation, but it does not take precedence over securing the airway in cases of acute respiratory compromise.