In the ABCDE approach to initial patient assessment, which component is the third?

• A. Airway
• B. Breathing
• C. Circulation
• D. Disability

Answer: (C)

In the ABCDE approach, the order of assessment is set to quickly identify and manage life threats. The third component is Circulation, which focuses on whether blood is effectively perfusing organs and tissues. After confirming the airway is open and the patient is adequately breathing, you assess circulation by checking the pulse, blood pressure, skin color and temperature, and capillary refill. These cues tell you if the patient is in shock or bleeding severely and whether immediate actions are needed, such as controlling obvious bleeding, securing IV access, and starting fluid or blood resuscitation. Getting circulation right is crucial because without sufficient perfusion, brain and organ damage can occur even if the airway is clear and the patient is breathing. The remaining steps assess neurological status (Disability) and uncover hidden injuries (Exposure), but the priority order moves next to evaluate and support circulation.