Overview: Primary Survey

Question 1

What info should be obtained from handover prior to arrival?

Answer 1

ETA

Mechanism of injury: inc details of patient position, other people injured, velocity/height/distance from blast

Time of injury and period of time in prehospital setting

Any on site interventions

Observations and pertinent findings

Question 2

What are the indications for admission to major trauma centre

Answer 2

central penetrating trauma

central crushing injuries

proximal amputtaions

> 2 # of leg bone

crushed/severely mangled limb

pelvic or depressed skull #

paralysis

High falls (>20 feet/6 meters in adults >10 ft/ 3m in children)

Motor-crash or motorcycle crash (>20mph)

Question 3

What investigations are usually performed in 1ry survey?

Answer 3

CXR
Pelvic XR
Urinary catheter
NGT
FAST Scan

Question 4

What are some investigations that MAY be done in 1ry survey but are usually;ly reserved for 2ry survey?

Answer 4

ECG
XR long bones ONLY if suspecting that is cause of shock
In gunshot injury AXR may be performed
Deep peritoneal lavage

Question 5

When would DPL be indicated?

Answer 5

Penetrating / blunt abdominal trauma that isn’t severe enough to warrant surgery immediately usually if things like CT not available