The ABC and pain in trauma.

Musculoskeletal trauma in the emergency setting is a challenge for orthopaedic surgeons. Life- and limb-threatening injuries of the extremities should be treated as soon as possible, since major musculoskeletal trauma can be the cause of significant bleeding. However, musculoskeletal trauma is often related to thoracic trauma. Management of the former should be performed only after patient's airway is maintained and breathing is secured with appropriate pain monitoring and management by expert anesthesiologists. This article discusses the association of musculoskeletal with thoracic trauma care and emphasizes on pain as a vital sign in trauma.