A young male sustained a gunshot wound to the abdomen during an altercation. As your partner is assessing and managing his airway, you should control the obvious bleeding and then:

• A. Auscultate bowel sounds.
• B. Assess for an exit wound.
• C. Obtain baseline vital signs.
• D. Apply a cervical collar.

Answer: (B)

After you stop the obvious bleeding, quickly checking for an exit wound helps you establish the projectile’s trajectory. Knowing whether the bullet has exited the body provides crucial clues about which organs or structures may be injured along its path and the level of contamination or shock risk you might be dealing with. This information guides your rapid transport decisions and the focus of the secondary survey, without delaying the patient for unnecessary tests.

Auscultating bowel sounds in the field isn’t reliable for assessing intra-abdominal injury and would waste valuable time. Obtaining baseline vital signs is important, but it’s part of ongoing monitoring rather than the immediate next step after bleeding control. A cervical collar isn’t indicated here unless there’s a suspected neck or spine injury, which isn’t the scenario described.