Surveys

Question 1

What are the components of PFSH.

Answer 1

Previous medical
Family
Social
He

Question 2

What are the components of DJTHREAD?

Answer 2

Diabetes
Jaundice
Thoracic
Heart
Rheumatic fever
Epilepsy
Asthma
Diverticulitis

Question 3

What are the components of SOCRATES?

Answer 3

Site
Onset
Character
Radiates
Associated symptoms
Time frame
Exacerbating/alleviating factors
Severity

Question 4

What does ATMIST stand for?

Answer 4

Age
Time of incident
Mechanism 
Injuries
S and S
Treatment

Question 5

What is the trauma scene size up?

Answer 5

Dynamic risk assessment
SICP
MOI
Number of patients
Triage?
Major incident?
Assistance?

Question 6

What is the trauma primary survey?

Answer 6

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General impression
  Visual head to toe
  Cat haemorrhage 
  AVPU - C-SPINE
  Airway breathing yes/no
  Radial pulse present? Indication of blood 
  pressure.
  Skin colour/temperature

Airway - C-SPINE
Patent?
(airway adjunct? NB CHECK SIZE)

Breathing
Rate: fast (more than 20)/slow (less than 12) /zero
(oxygen applied - CHECK JRCALC)

  Rule out ATOM FC
  Inspect
  Palpate
  Auscultate
  Percuss

(dressing/decompression)

Circulation
Haemorrhage control
(dressing/tourniquet)
Inspect/Palpate abdomen (rigidity, guarding)
Check pelvis (symmetry, deformity, pain) (pelvic binder - CHECK PMS)
Check femurs (trac3 - CHECK PMS)
CRT/skin colour/temp/moisture

Disability
GCS
Abnormal behaviour drugs/alcohol

Exposure/environment
Maintain patient comfort/minimise risk of triad
Expose all other areas-limbs threatened?

Treatment
ANNOUNCE PRIMARY SURVEY RESULT. Is it time critical - transport? - helmed?
Access and fluid therapy (increase volume of fluid in vascular space inc cardiac output and perfusion)
(IV/IO/Fluid/TXA (TXA - anti fibrinolytic )
Life threatening conditions treated.

Question 7

What is the trauma secondary survey?

Answer 7

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Head
Boggy masses, cerebrospinal fluid (nose/ears)
battle sign, bilateral peri orbital ecchymoses
(raccoon eyes).
Palpate skull/facial bones
Inspect pupils
Recheck airway

Neck
  TWELVE
  Tracheal deviation
  Wounds/bleeding
  Subcutaneous emphysema 
  Laryngeal injury (crepitus/hoarseness)
  Venous distension
  Expose neck/Palpate c-spine if not already
  collared

Chest
Reassess chest
Auscultate heart sounds
Rate and SPO2

Abdomen
Inspect and palpate looking for rigidly and
guarding

Pelvis
Inspect/Palpate if not already treated
Check for bladder or bowel control problems
Check for priapism.

Back
Only log roll if necessary and with sufficient man
power i.e. suspected penetrating trauma or cat
haemorrhage

Upper limbs
Inspect from proximal to distal starting at clavicles.
Check pulse/crt/motor/sensory/colour/temp
Lower limbs
Start from hip/groin
Check distal pulse/motor/sensory/colour/temp

VITAL SIGNS

SAMPLE HX
NB last oral intake
Events prior - was it medical initially?