Primary survey PDF

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primary survey notes...

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Primary survey Asses danger is the scene safe to approach. Slip or trip hazards. Rtc – traffic glass on road. Concerned gonna get stabbed. Animals, other people. Communicate with EOC, if possible to remove/reduce hazards. I.e police to stop traffic. Dynamic risk assessment TILE for manual handling. Dynamic risk assessment: Anaylzye situation or task Select a safe system of work – hierarchy of control = eliminate, reduce, isolate, control, ppe, discipline Dynamically assess they system of work Are the control measures employed adequate to manage the identified risks - - if not reassess safe systems of work Yes – carry it task Review Could ask us what potential risk could occur. Old lady fallen = what dangers? Icy weather slip or trip? Get another crew to carry down then stairs End of bed assessment – visual aid only and look at patient and what can I see. Look well or not well? General impression – colour, eye contact, patient positioning , in any obvious pain Level of response – A – alert, V-voice, P-pain, U – unresponsive ==== introduce myself and ask their name Ask for consent for P and U Gain consent if aware and can talk Primary survey – the identification and treatment of any immediately life- threatening conditions. If intervene during primary survey (other than oxygen) they are primary survey positive (C)A(c)BCDE approach Catastrophic haemorrhage – severe external blooding that is life-threatening – arterial bleeds, traumatic amputations, significant amount of bloods Asses and treat catastrophic bleed moving onto airway and breathing. To stop use tornaquays (sometithing to tie around to stop the bleeding) medication to clot blood. Put hands under the hollow of patients back and under knees as blood can pool there without us seeing Airway – if reduced level of consciousness Open airway and look inside – vomit, blood, loose teeth, foreign body and remove anything found Ope airway using airway manoeuvre – head-tilt, chin lift (HTCL), jaw thrust If suspecting a c-spine injury Apply suction if required Airway adjunct if required (if there is a risk that the patient cannot maintain their own airway) – oropharyngeal airway, nasopharyngeal airway Consider c-spine at this point – apply manual in-line stabilisation

If the patient cant maintain airway consider suctioning if gurgling in airway. Mains operated/battery powered or hand held in kit bag 2 types of suction catheter . Yanaur – rigid, wide- bore catheter or smaller flexible one that can go through an i gel. Only suction when withdrawing out Use suction for a short amount of time as aren’t oxygenated them

Aspirating – breathe in food or fluid. Causes respiratory problem Oropharyngeal airway – use in an unresposive patient with an absent gag reflex. This prevents tongue Nasopharyngeal airway – intact gag reflex or where Trsismus – jaw clenches/spasms so cant open mouth Doesn’t prevent aspiration or vomiting Can cause bleed if shove to hard so possibly more risk If any of these manoeuvres used they are primary survey positive Breathing – initial breathing assessment – is it adequate rate, rhythm and depth with equal (bilateral) air entry throughout It is not a full respiratory rate- part of vital signs in secondary survey More of an indication of whether I need to intervene...