Primary & Secondary Survey

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Presentation transcript:

Primary & Secondary Survey Patient Assessment Primary & Secondary Survey

Patient Assessment Where do you start? You are called to the scene of a Road Traffic Accident, where you find a 24 year old pedestrian has been thrown fifteen feet after been hit by a car.The man is unconscious and has blood coming from his mouth and from the back of his head. He also has obvious deformity of his left arm, and a compound fracture of his right femur. Where do you start?

Patient Assessment Scene Safety Universal Precautions Number of Casualties Mechanism of Injuries Do I need Assistance explain about pneumonics

General Impression Environment Age Gender Apparent Life Threatening Injuries

Primary Survey This is the systematic approach for every patient assessment Identify and treat life threatening injuries  A B C c D E how do we remember the approach very difficult (humour) abccde vital signs explain about importance of baseline vitals patient improves or disimproves

Secondary Survey Systematic head to toe assessment Identify any other injuries Vital Signs

Primary Survey A airway B breathing C circulation and bleeding c apply a cervical collar D disability AVPU E expose and examine (rapid)

Trauma Jaw Thrust Explain about airway Tongue attached to jaw Blood, vommit, foreign body, teeth

Assess breathing.(10 seconds)

Breathing LOOK, LISTEN AND FEEL FOR 10 SECONDS. MAJOR CHEST TRAUMA. RISE AND FALL OF THE CHEST. ABNORMALLY FAST OR SLOW. REGULAR OR IRREGULAR. LABOURED BREATHING. NOISY BREATHING. USE OF ASSESSORY MUSCLES. EQUAL CHEST EXPANSION.

Assess Circulation: Pulse, Bleeding (10seconds)

Circulation LOOK FOR AND CONTROL ANY LIFE THREATENING BLEEDS IS PULSE PRESENT? FAST OR SLOW? REGULAR OR IRREGULAR? WEAK OR STRONG? LOOK FOR AND CONTROL ANY LIFE THREATENING BLEEDS

Look for and control severe bleeding.

Collar Supine Patient

Disability A V P U Alert Verbal Painful stimuli Unresponsive

Alert-Aware of Person, Place and Time.

Stimulus But May Be Confused Responds To Verbal Stimulus But May Be Confused

Responds Only To Painful Stimulus

Expose and Examine Rapidly Head Neck Chest Abdomen Pelvis Extremities (Proximally)

Vital Signs Vital signs must be taken after Primary and Secondary surveys. Breathing rate Pulse Blood Pressure

Listen to both sides of the chest. Is air entry present? Absent? Equal on both sides? Compare left side to right side. Mid-clavicular Mid-axillary

Secondary Survey Head to toe assessment Assess CSM’s at extremities C circulation S sensation M motor function

Circulation / Capillary Refill Sensation, Motor Function

What Injuries? Deformities Contusions Abrasions Punctures / Penetrations Burns Tenderness Lacerations Swelling D C A P B T L S

Deformities

Contusions

Abrasions

Punctures/Penetrations

Burns

Tenderness

Lacerations

Swelling