20-09-21 Primary Survey

Question 1

What are the stages of the primary survey?

Answer 1

• DRABC
• Danger, response, airway, breathing, circulation

Question 2

Give some signs of airway obstruction.

Answer 2

• Turning blue
• Choking or gagging
• Noisy breathing or wheezing
• Vomiting
• Sudden violent coughing

Question 3

Describe what happens to the airway when the actions of head tilt/chin lift are performed.

Answer 3

• This will displace the mandible anteriorly, which will lift the epiglottis away from the glottic opening, opening the airway

Question 4

What could obstruct the airway?

Answer 4

• Inhaling/swallowing foreign object
• Allergic reaction
• Trauma to the airway from an accident
• Bacterial/viral infections

Question 5

Why is it safer for the spontaneously breathing patient to be in the recovery position rather than supine?

Answer 5

• The recovery position will keep the patient’s airway open
• It also ensures fluids or vomit won’t cause them to choke

Question 6

What should you do if you suspect head or neck trauma?

Answer 6

• Provide as much first aid as possible without moving the head or neck
• If the person shows no sign of circulation, begin CPR, but do not tilt the head back to open the airway
• Use the fingers to gently grasp the jaw and lift it forward (jaw thrust)
• Safer as it lifts the contents of the oropharynx (tongue and soft tissues) away from the posterior wall of the pharynx (if the mandible is intact) without affecting the cervical vertebrae
• If the person has no pulse, begin chest compressions.

Question 7

Why is re-assessment important?

Answer 7

• To check if the patient’s status has changed.
• Their airway may have become blocked again, they may have lost consciousness or stopped breathing

Question 8

What is CPR?

Answer 8

• Cardio-pulmonary resuscitation

Question 9

What is a pulse?

Answer 9

• Your pulse is your heart rate or the number of times your heart beats in a minute

Question 10

What is the normal pulse rate?

Answer 10

• Most adults have a resting heart rate of 60-100bpm

Question 11

When is the term bradycardia appropriate?

Answer 11

• Bradycardia is a slower than normal heart rate
• Generally considered to be lower than 60bpm

Question 12

When is the term tachycardia appropriate?

Answer 12

• Medical term for heart rate over 100bpm

Question 13

Why is the carotid pulse the best to use in an emergency situation?

Answer 13

• The carotid pulse does not disappear under low blood pressure conditions
• It is the strongest pulse as it passes near the surface of the neck.
• The absence of a pulse means cardiac arrest has occurred.

Question 14

Where else can we find a large calibre artery in an emergency situation?

Answer 14

• In a conscious adult, the radial artery can be used
• Its less invasive, and less invasive procedures should follow before more aggressive ones
• In some cases of emergencies, all pulses of limbs may be checked if there’s worry of critical limb ischemia, requiring immediate attention to save the limb

Question 15

Why should you feel for the carotid on one side at a time?

Answer 15

• The carotid arteries feed the brain.
• By pressing down on both sides of the neck, this can stimulate the vagus nerve and compromise arterial blood flow to the neck, leading to strangulation
• If someone uses the thumb and third finger on the same hand, this could lead to strangulation.
• The person could also feel the pulse in their own thumb and fail to initiate CPR to someone without a pulse.

Question 16

What are the advantages of pocket mask ventilation over mouth-to-mouth ventilation?

Answer 16

• Removes the need for mouth-to-mouth resuscitation, reducing the spread of harmful pathogens.
• Superior seal on patients face, allows responder to perform jaw thrust on patient with spinal injury

Question 17

What does the term FiO2 mean?

Answer 17

• Fraction of inspired oxygen
• The concentration of Oxygen in a gas mixture
• The gas mixture at room air has a fraction of inspired oxygen of 21%, meaning the concentration of oxygen in the room is 21%
• In medicine, FiO2 is the assumed % of oxygen concentration participating in gas exchange in the alveoli.

Question 18

1. What is the FiO2 of expired air ventilation? (Room air is 21% or 0.21)

Answer 18

• 16%

Question 19

Why might you be able to give effective breaths when the patient becomes unconscious?

Answer 19

• When the patient is unconscious, they wont panic, making procedures, such as CPR, head tilt/chin lift and jaw thrusts easier to perform
• Their breath will also not cause resistant against your breathes, making effective breathes easier.

Question 20

In which age group is choking most common?

Answer 20

• Choking is the fourth leading cause of unintentional death in children under the age of 5.
• Children under age 5 are at greatest risk for choking injury and death.
• Toys, household items and foods can all be a choking hazard.
• The most common cause of nonfatal choking in young children is food.

Question 21

1. What is meant by the term cyanosis?

Answer 21

• A bluish discoloration of the skin due to poor circulation or inadequate oxygenation of the blood.