1. Primary & Secondary Survey
Patient Assessment
Primary & Secondary
Survey

2. 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?

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

4. General Impression Environment Age Gender
Apparent Life Threatening Injuries

5. 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

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

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

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

9. Assess breathing.(10 seconds)

10. 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.

11. Assess Circulation: Pulse, Bleeding (10seconds)

12. 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

13. Look for and control severe bleeding.

14. Collar Supine Patient

15. Disability
A V P U
Alert
Verbal
Painful stimuli
Unresponsive

16. Alert-Aware of
Person, Place and Time.

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

18. Responds Only To Painful Stimulus

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

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

21. 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

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

23. Circulation / Capillary Refill Sensation, Motor Function

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

25. Deformities

26. Contusions

27. Abrasions

28. Punctures/Penetrations

29. Burns

30. Tenderness

31. Lacerations

32. Swelling