Primary and Secondary Survey Flashcards
TCCC primary survey
Massive hemorrhage
Airway
Respirations
Circulation
Head injury and hypothermia
Used as a primary adjunct for massive or arterial bleeding until controlled by dressing or hemostatic agents
Tourniquet
In general, loss of up to ________ of circulating blood volume, is tolerated well in healthy patients.
15 percent (about 750 mL)
Class I hemorrhage
There is minimal or no tachycardic response, and changes in blood pressure usually do not occur. Without further bleeding, fluid replacement therapy is usually not needed.
Class I hemorrhage (15%)
Blood loss of ________ of total blood volume, generally results in tachycardia and narrowed pulse pressure.
15 to 30 percent (about 750 to 1500 mL)
Class II hemorrhage
There may be mild mental status changes. Provided the casualty had a normal RBC volume before hemorrhage, this degree of blood loss is tolerated without RBC replacement provided circulating volume is restored.
Class II hemorrhage (15-30%)
As blood loss increases beyond ____________ there is worsening hypotension, tachycardia, peripheral hypo perfusion, and decline in mental status
30 percent (1500 mL)
Class III hemorrhage
At greater than ____________ the ability of the body to compensate has reached its limits and hemodynamic decompensation is imminent without effective resuscitation.
40 percent (2 Liters) blood loss
Class IV hemorrhage
Look, listen, and palpate from nose/mouth to trachea/bronchial tree
Airway
Should be part of the first response for a patient making inadequate respiratory effort.
Chin Lift/Jaw thrust maneuver simultaneously with in-line head and neck stabilization followed by insertion of an oral or nasal airway
Inspect to identify any abnormalities
Auscultate for presence or absences of breath sounds
Respirations
Intervention for tension penumothorax
Needle thoracostomy
Intervention for hemopneumothorax
Chest tube
Intervention for sucking chest wound
Occlusive dressing
Circulation is divided into two parts:
Hemodynamic Status
Hemorrhage Control
Evaluation of level of consciousness, skin color and presence and magnitude of peripheral pulses
Hemodynamic Status (Circulation)
Should not be used for measurement during the primary survey of circulation.
Rapidly obtain information by consciousness, pulse, skin color, and capillary refill time
Blood pressure measurement
Systolic pressure if radial pulse is felt
> 80 mmHg
Systolic pressure if femoral pulse is felt
> 70 mmHg
Systolic pressure if coratid pulse is felt
> 60 mmHg
Provides a rapid initial assessment of peripheral perfusion.
Skin Color and Cap Refill