Presentation on theme: "Primary Survey. When do you use it? What is it? Rapid assessment Identify anything that can kill Pt Look for anything that’s not right Not just for."— Presentation transcript:
What is it? Rapid assessment Identify anything that can kill Pt Look for anything that’s not right Not just for trauma Not just for unconscious people It’s on every PRF Easy to remember – work down the body Should be less than 1 min
DR ABCDE Danger Response (Summon help) Airway (with C-spine considerations) Breathing Circulation Disability / dysfunction Expose Deal with each as you come to it!
Danger Have a proper look! How many patients? Size up the scene (what could have caused injury?)
Response Have a look at Pt – big sick or little sick? Approach from feet AVPU Question, command, pain PAIN – how do we check this? Note how response changes
Response - If Alert? If talking, airway OK NOTE – obstructed airway? If talking, breathing OK NOTE – breathing difficulty? Assess circulation Pulse, skin colour / moisture / temperature
Response - If NOT Alert? If alone, shout help If in a first aid team, shouldn’t be alone Do you call for backup (ETA, HCP) ???
Airway (with C-spine considerations) Check C-spine Feel down back of neck (tenderness, irregularities) Check jaw Feel across mandible (fracture obstructing airway?) Check mouth Any obvious obstructions? Take em out Action - Head tilt & Chin lift OR Jaw thrust?? When would you do this? Check neck Trachea OK? Swelling? Discoloration?
Breathing Check breathing for 10 secs NB agonal breaths don’t count Someone to take over head tilt / chin lift? Check chest If appropriate, LOOK at the chest Anything odd? Bruising, swelling,.. knife? Palpate (Feel) chest Check for equal expansion Breathing fast or slow (don’t need resp rate)
Circulation “Blood on the floor and 4 more” Can bleed to death internally – looking for this
Circulation Check abdomen Bruising? Discoloration? Swelling? Wounds? Feel abdomen Palpate the four quarters (feel for hardness, watch for tenderness)
Circulation Feel pelvis Check for position of iliac crests Do not ‘spring’ the pelvis!! Feel femurs Start at the TOP (yes, by the crotch) Firm grip, go down to the knee Check back for blood Check PULSE in both wrists Don’t need a pulse rate – just is it fast or slow? Check skin colour
Disability / Dysfunction Feel around head Deformity (fractured skull)? Blood? Check voice response Check pain response Squeeze trapezius muscle (neck/shoulder) Eyes open? Hands move? Check motor ability Ask em to squeeze your fingers