Primary/Secondary Survey

Question 1

what system is used to assess a primary survey?

Answer 1

ABCDE

Question 2

what system is used to assess a secondary survey?

Answer 2

AMPLE

Question 3

what does ample stand for?

Answer 3

allergies 
medication 
PMH 
last meal and drink 
events

Question 4

what does ABCDE stand for

Answer 4

airway 
breathing 
circulation 
disability 
environment

Question 5

How is airway assessed?

Answer 5

ask patient a question and if they answer then airway is patent
any additional sounds from mouth such as stridor
look in mouth for any foreign bodies, may have to use suction as well

Question 6

what manoeuvre can be done to open someones airway?

Answer 6

jaw thrust

Question 7

what adjuncts can be used if airway is compromised?

Answer 7

NPA - nasopharyngeal airway

OPA - oropharyngeal airway

Question 8

why would a NPA (nasopharngeal airway) be used rather than a OPA?

Answer 8

NPA are sued when there is a gag reflex present

Question 9

what procedure can be done for emergency airway?

Answer 9

needle cricothyroidotomy

Question 10

state two definitive airways ?

Answer 10

endotracheal tube

tracheostomy

Question 11

what do definitive airways prevent

Answer 11

aspiration

Question 12

how do you maintain a stable C spine?

Answer 12

place patient in hard collar and sandbags with tape

Question 13

how much oxygen should be started to help with breathing

Answer 13

15L of oxygen with a non rebreathe mask (Hudson)

Question 14

what assessment should be done for breathing?

Answer 14

O2 sats 
position of trachea
RR and chest expansion 
breath sounds and vocal resonance 
percussion 
ABG

Question 15

what are 7 signs of a tension pneumothorax?

Answer 15

respiratory distress 
increased JVP 
decreased BP 
tracheal deviation 
decreased air entry
decreased vocal resonance 
hyper resonance percussion (sounds hollow)

Question 16

what is the immediate management of a tension pneumothorax ?

Answer 16

insert large bore venflon into 2nd intercostal space, mid clavicular line

Question 17

what is the gauge of a large cannula?

Answer 17

14/16G

Question 18

how to you assess circulation?

Answer 18

pale, sweaty, active bleeding
BP, HR, JVP, heart sounds, cardiac monitor
consciousness

Question 19

state some sites of haemorrhage ?

Answer 19

chest
abdo
pelvis (use pelvic binder)
floor

Question 20

what is the management of a haemodynamic comprised patient ?

Answer 20

give 2L of warmed Hartmanns stat

Question 21

what is the one thing to never forget when using ABCDE ?

Answer 21

ALWAYS REASSESS

Question 22

what three things can be measured to assess response to fluids?

Answer 22

lactate, BP, urine output

Question 23

what things should be assessed for disability ?

Answer 23

consciousness - AVPU, GCS
pupil response
plasma glucose!!!
(never forget glucose)

Question 24

what should be assessed for exposure ?

Answer 24

completely undress the patient
perform leg role and PR
look for bleeding
prevent hypothermia

Question 25

what should be done in secondary survey?

Answer 25

head to toe examination

Question 26

what investigations should be done for secondary survey ?

Answer 26

C spine - lat and peg 
CXR 
Pelvis XR 
FAST scan 
CT - when pt is stable

Question 27

what is a peg x ray?

Answer 27

The odontoid or ‘peg’ projection is an AP projection of C1 (atlas) and C2 (axis) with mouth open

Question 28

what does FAST scan stand for?

Answer 28

focussed assessment with sonography in trauma

Question 29

what system is used to clear the C spine?

Answer 29

NEXUS criteria

Question 30

what does NEXUS criteria consist of ?

Answer 30

fully alert and orientated 
no head injury 
no drugs or alcohol 
no neck pain 
no abnormal neurology 
no distracting injuries