Which of the following is NOT one of the double-starred criteria used in the initial TNP assessment?

• A. Alertness and Airway
• B. Breathing and Ventilation
• C. Circulation
• D. Pain control

Answer: (D)

In the initial trauma assessment, the focus is on rapid life-saving priorities: the patient’s airway with protection of the spine and their mental status, breathing/ventilation, and circulation. These elements are considered double-starred because they signal immediate actions to prevent deterioration. Pain control, while important, is not part of this rapid primary survey; analgesia is addressed after the patient’s airway, breathing, and circulation have been stabilized, or as part of ongoing care once stabilization is achieved. The other components fit because they represent the core aspects evaluated first: ensuring the patient is alert and has a secure airway, confirming adequate breathing and ventilation, and assessing circulation and perfusion.