During the Primary Survey, when is control of major bleeding performed?

Control of major bleeding is performed during the initial assessment of the Primary Survey because it is a critical aspect of identifying and addressing life-threatening conditions. The Primary Survey focuses on assessing and managing the most immediate threats to life, which include airway, breathing, circulation, disability, and exposure—often summarized as the ABCDEs.

When major bleeding is identified during this initial assessment, it requires prompt intervention to ensure the patient does not exsanguinate, which can lead to shock and potentially be fatal. Therefore, controlling major bleeding is integrated into the early steps of the Primary Survey, ensuring that it is addressed as quickly as possible to stabilize the patient's condition before moving on to further assessments or interventions related to airway management, breathing, and other concerns.

The timing of bleeding control is crucial; it cannot wait for a complete secondary survey or be delayed until after airway management if significant bleeding is present. Addressing the most significant threats to life takes precedence, and controlling major bleeding fits the urgency of this requirement.