 Primary Survey (D,R,C,A©,B,C?)  Help organised  Dealt with life-threatening conditions

 What happened to our Pt, and how bad are they?  Observations (vital signs)  Disability – level of response  Expose / Examine  History  Symptoms (how they feel)  Signs (what you find) SAMPLE

 Response  Breathing  Pulse  Blood Pressure  Temperature  Oxygen saturation  Why?  How sick are they?  They getting worse or better?  Do lots, pass onto HCP

 Rate  Depth (shallow?)  Ease (difficulty breathing?)  Noise (what noises?)  Smell  Think about why the breathing is as it is

 Felt where arteries close to the surface  In kids, brachial pulse  Looking at: ◦ Rate (what do we expect?) ◦ Strength ◦ Rhythm  Take one!  Take it early!  What affects pulse?

 Can we get an idea of what the blood pressure is?  Make a record of how it changes

 Can we get an idea of body temperature?  Skin!  Keep Pt warm

 Level of response  Change in level of response  AVPU  If Alert, how alert? Oriented?  GCS? When?

 Properly expose!!  BUT.. Remember: ◦ Pt comfort (hypothermia!) ◦ Modesty  Male / female FA?

 AMPLE  What happened?  Sources of info? ◦ Patient? ◦ Bystanders ◦ Scene  Mechanism of injury  L.O.C  Have they moved?

 Allergies ◦ Especially to drugs  Medications ◦ Clue to what’s wrong? ◦ Been taking em?  Past medical history ◦ Relevant?  Last meal & drink ◦ Inc. alcohol & drugs  But…What if they can’t talk to you??

 What the patient feels  Ask as much as possible!  Chief complaint?  Characteristics of pain  Other symptoms (L.O.C, nausea, dizziness, vomiting, hunger, confusion, visual disturbances, pins and needles, numbness, weakness, sensations etc…)  Negatives!

 O,P,Q,R,S,T  Onset  Provocation (what makes it worse)  Quality  Radiation (location + where does it go)  Severity (0-10)  Timing

 What you find ◦ Look ◦ Feel ◦ Move ◦ Smell ◦ Listen  Bad Stuff: bleeding, fluids, swelling, discoloration, deformity, warmth, crepitus…  Compare both sides!