Primary Survey

Question 1

Initial impressions

Answer 1

• Reaction to greeting
• perfusion + posture
• obvious distress or discomfort

Question 2

Airway

Answer 2

Assess:
- Consciousness
- Ability to take a deep breath
- Ability to speak (word, phrase, sentences)

Look:
- Actual obstruction (complete, partial, foreign bodies, swelling, trauma)
- Potential obstruction (swelling)

Question 3

Breathing

Answer 3

Assess
- Look, listen, feel
- RR
- Work of breathing (effort/efficiency)
- Auscultate chest

Look:
- Increased resp effort (tachypnoea, accessory muscles, intercostal recession)
- Decreased resp effort
- Decreased air entry (unilateral/bilateral)
- Abnormal breath sounds (wheeze/crackle)
- fatigue, cyanosis, hypoxia

Question 4

Circulation

Answer 4

Assess
- Life threatening haemorrhage
- HR
- peripheral & central perfusion (skin temp + colour, cap refill, pulse volume + rhythm

Look
- Uncontrollable haemorrhage
- Tachy/Brady
- Poor brain perfusion (ALOC, restlessness)
- Poor skin perfusion (cold/pale/sweaty, cap refill >2sec

Question 5

Disability

Answer 5

Assess
- LOC (AVPU or GCS)
- Pupil size and function
- Ability to walk/move limbs

Look
- ALOC
- Hx of loss of consciousness
- Pain
- Poor coordination or balance
- Unsteady gait

Question 6

Exposure/Environment

Answer 6

Assess
- Expose + inspect torso and limbs

Look
- Rash or petechiae
- Contusions or discolouration
- Signs of injury

Question 7

Focused Hx and adjuncts

Answer 7

Assess
- BP
- BGL
- SpO2
- Temp
- ECG
- Worthing Physiological Score

Look
- BP S+D
- BGL < 4mmol/l > 17mmol/l
- Assess condition, resp effort, TV
- Temp < 36.0 > 38.5
- Dysrhythmias
- Score > 1 = transport

Question 8

Questions

Answer 8

• What is the main reason for calling an ambulance?
• Current chest pain or breathing difficulty?
• When did it start?
• What were you doing when it started?
• How severe is it?
  -Getting better or worse?