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Primary trauma survey
The document provides guidance on performing a primary trauma survey to assess a patient's airway, breathing, circulation, disability, and exposure (ABCDE). It outlines steps to take for each component, such as opening the airway using jaw thrust, assessing breathing rate and quality, feeling for pulses and controlling hemorrhaging, determining Glasgow Coma Scale score, and maintaining body temperature while fully exposing the patient. Special considerations are given for IV fluids, pregnancy, mechanisms of injury, and calculating a Revised Trauma Score.
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Primary trauma survey
- 1. Primary Trauma Survey Aries GlennB. Galao, BSN, RN
- 2. AIRWAY MANAGEMENT AND CERVICALSPINE IMMOBILIZATION
- 3. • Open airwayusing the jaw-thrust method. • Assess airway for compromise and/or obstruction • Suction nasal/oral pharynx to clear blood, secretions, or debris
- 4.
- 5. • Assess respirationsfor: – Rate, depth, quality, effort • Inspect and palpate chest • Auscultate lung fields for diminished or absent breath sounds if ventilation is abnormal • Manually ventilate with BVM if breathing is absent or inadequate
- 6.
- 7. • Assess pulsefor: – Presence, quality, regularity • Begin chest compression if no pulse can be detected • Assess: – Skin color, temperature, moisture, capillary refill • Control hemorrhage with direct pressure
- 8.
- 9. • Determine andestablish a baseline GCS (Glasgow Coma Scale) Score – May use AVPU • Assess pupils – PERRLA (Pupils Equal and Round, Reactive to Light and Accomodation)
- 10.
- 11. • Remove clothing •Assess entire patient for injury and hemorrhage • Maintain body temperature by keeping the patient covered
- 12. • Log rollto inspect and palpate posterior surfaces • Immobilize entire body – Use a c-spine collar and long board
- 13.
- 14. IV Fluids andBlood • LR is the fluid of choice in trauma patients • CAUTION: LR contains calcium which causes donor blood to clot in the IV tubing • If a blood transfusion is likely, then NS is the fluid of choice
- 15. Pregnancy • Cervical spineimmobilization – Pregnant women (>24wk) should be immobilized in the left lateral position if possible to avoid compression of the vena cava, which causes supine hypotension
- 16.
- 17. Motor Vehicle Accidents(MVA) • Direction of impact • Speed at impact • Condition of vehicle • Use of seatbelts or airbags • Ejection from vehicle • Was any other passenger from the same vehicle killed • Delayed transport due to extrication from vehicle • Chest or abdominal bruising from steering wheel or seatbelt
- 18. • Falls – From what height – Onto what type of surface • Penetrating Trauma – Weapon – Site and depth of injury – Underlying organs – Weapon-patient distance – Caliber and velocity of bullet
- 19. • Burns – Degree of burns – % total body surface area (TBSA) – Associated trauma
- 20. REVISED TRAUMA SCORE(RTS) COMPONENT FINDING VALUE Respiratory Rate 10-29/min 4 >29/min 3 6-9/min 2 1-5/min 1 Apnea 0 Systolic Blood Pressure >89 4 76-89 3 50-75 2 1-49 1 Pulseless 0 Glasgow Coma Scale Score 13-15 4 9-12 3 6-8 2 4-5 1 0-3 0
- 21.