ITLS Primary survey

Question 1

1st step Scene size up (SPERM)

Answer 1

Safety (standard precautions, PPE, scene hazards) 
People (#of pts, bystanders)
Environment (date, time, weather) 
Resources (backup, rescue)
Mechanism of injury

Question 2

SPERM then Initial assessment

Answer 2

Initial assessment, sawlogs
Sex
Age
Weight
Life threatening bleed
Obvious injuries
General appearance
Skin colour
\+
Purposeful movement
Pt positioning

Question 3

Initial assessment then

Answer 3

CABC if needed

Question 4

Initial assessment, assess for CABC, then

Answer 4

LOC

AVPU, CC/symptoms

Question 5

LOC then

Answer 5

Airway. Consider C-spine here

Snoring, gurgling, stridor, silence, secretions

Question 6

Airway then

Answer 6

Breathing
Present?
Rate, depth, effort

Question 7

Breathing then

Answer 7

Circulation
Rate, rhythm, quality
Skin colour, temp, moisture, cap refill
Has bleeding been controlled?

Question 8

Circulation then

Answer 8

Decide on rapid trauma survey or focused exam

Question 9

Circulation then (rapid trauma exam)

Answer 9

Head and neck:

JVD, tracheal deviation

Question 10

Head and neck then

Answer 10

Chest:
Asymmetry (w/paradoxical motion?)
Contusions, penetrations, tenderness, instability, crepitation
Breath sounds (present, equal, percussion)
Heart tones

Question 11

Chest then

Answer 11

Abdomen:

Contusions, penetration, evisceration, DRT

Question 12

Abdomen then

Answer 12

Pelvis

Tenderness, instability, crepitus

Question 13

Pelvis then

Answer 13

Lower/upper ext
Obvious swelling, deformities
Motor and sensory function

Question 14

Lower/upper ext then

Answer 14

Posterior:
Penetrations, obvious deformity.
Load and go

Question 15

Load and go then

Answer 15

If radial pulse is present, pulse, breathing, BP

If altered mental status Pupils size, reactive, equal and GCS

Question 16

GCS eyes

Answer 16

Spontaneous
Voice
Pain
None

Question 17

GCS Verbal

Answer 17

Oriented
Confused
Inappropriate
Incomprehensible
Silent

Question 18

GCS motor

Answer 18

Obeys
Localizes
Withdraws
Abnormal flexion
Abnormal extension
No movement