Primary Survey

Question 1

When you receive a pre alert, what do you need to consider to make sure you are ready?

Answer 1

C - is there likely to be bleeding? Prime the rapid infuser?request blood products?
A- is the patient intubated? Will they need intubation? Specialist equipment ready?
B - traumatic injury? Chest drain?
C - appropriate IV access? Trauma line? IO?
D - mechanism of injury, traumatic brain injury? Neurosurgeons? Specialist meds? Warming?
E - all specialist equipment ready? Appropriate specialities? Allocated roles? Appropriate checklists?

Question 2

What is included in a primary survey?

Answer 2

C-ABCDE

C - compressible haemorrhage and cspine
A - airway
B - breathing
C - circulation
D - disability
E - exposure/everything else

Question 3

Where would you find a compressible haemorrhage?

Answer 3

Scalp
Trunk
Limb
Face

Question 4

When assessing the cspine in a primary survey what are you assessing for?

Answer 4

Is the cspine protected appropriately?

Question 5

When assessing the airway in a primary survey, what are you looking for?

Answer 5

Is the airway clear and is the patient breathing?
Is there any deformed anatomy of the face and mouth?
Is there any visible blood or teeth in the oropharynx?
What interventions have been made?

Question 6

What is the acronym for a breathing assessment in a primary survey and what does it mean?

Answer 6

RIPPAS

R - respiration rate
I - inspection
P - palpation
P - percussion
A - auscultate
S - sats

Question 7

What are you assessing for in circulation during a primary survey?

Answer 7

What is the patients colour?
Any signs of haemorrhage? Think shock!
What interventions are in place?
HR, BP, CO2?
Long bone deformity?
Full stab check!
Radial pulse present?
Is the patient warm or cold to touch?
What is their cap refil?
What is their temp?
Abdo- any distension, bruising, tenderness, peritonism?
Pelvis - is there a binder present? Don’t spring the pelvis!!
Female patient - gravid uterus?

Question 8

What are you assessing for in disability in a primary survey?

Answer 8

GCS?
Has the patient moved all 4 limbs?
What is the pupils size and are they reacting?
Male patients - any priapism?

Question 9

What are the key elements of Crew Resource Management?

Answer 9

Communication, leadership, decision making, situation awareness, monitoring, cross checking