Beyond Simple Vital Signs

Question 1

What is a primary survey?

Answer 1

Using a systematic assessment tool to assess and treat in order of priority for undiagnosed and/or acutely unwell patients

Question 2

What are the steps/priorities of the primary survey?

Answer 2

A - Airway maintenance with cervical spine support
B - Breathing and ventilation
C - Circulation with haemorrhage assessment
D - Disability (eg. neurological)
E - Exposure with temperature control

Question 3

What do you look for in Airway?

Answer 3

Assess for obstuction. Are they snoring, do they have stridor or stertor, gurgling or wheezing. If unconscious and lying prone, has their tongue falled back and obstructed the airway? Is there vomit, broken teeth or other blockages.

Question 4

What do you look for in Breathing?

Answer 4

Rate and depth and rhythm of respiration

Question 5

What do you look for in circulation?

Answer 5

If no pulse, start CPR. Peripheral pulse rates, strength and rhythm, skin colour, haemorrhage.

Question 6

What do you look for in Disability?

Answer 6

GCS and blood glucose if necessary

Question 7

What to you look for in exposure?

Answer 7

remove clothing in sections to assess for hidden injuries or signs of distress.

Question 8

What are the additional steps to be completed at start of a primary survey?

Answer 8

D - Danger
R - Response
S - Send for help

Question 9

What is the DRSABCDE for Basic Life Support?

Answer 9

Danger
Response
Send for Help
Airway
Breathing
CPR
Defib
Environment

Question 10

Life threatening airway problems

Answer 10

obstruction
inhalation injury (eg burns, chemical inhalation)

Question 11

Life threatening breathing problems

Answer 11

Tension pneumothorax
pneumothorax
haemothorax
open pneumothorax (sucking chest wound)
flail chest
full thickness circumferential burn of thorax

Question 12

classes of haemorrhagic shock

Answer 12

class I (up to 15% or 750mL blood loss)
class II (15-30% or 750-1500mL)
class III (30-40% or 1500-2000mL)
class IV (>40% or >2000mL)

Question 13

Life threatening circulation problems

Answer 13

external haemorrhage
shock
pericardial tamponade

Question 14

AEIOU mnemonic to accompany GCS

Answer 14

if the cause of impaired consciousness is found to be none of the below, it is considered traumatic
A - alcohol/drugs
E - endocrine, encephalopathy
I - insulin
O - opiates and oxygen
U - uraemia