Trauma

Question 1

What is the primary survey?

Answer 1

Identifies most life-threatening injuries and management is instituted simultaneously

Performed by one person – the trauma lead will appoint someone to do this

Question 2

What is the secondary survey?

Answer 2

• AMPLE Hx - allergies, medications, PMH, last meal, events
• Physical exam head to toe incl rectal exam
• Reassessment of vitals
• Diagnostic studies - CT trauma series (CT CAP) +/- CT head

Question 3

Which life-threatening emergencies are you looking for in B of the primary survey?

Answer 3

• Tension pneumothorax
• Open pneumothorax
• Massive haemothorax
• Flail chest

Question 4

Which life-threatening emergencies are you looking for in C of the primary survey?

Answer 4

Shock (Cardiogenic, Hypovolaemic, Obstructive, Distributive)

Cardiac tamponade

Question 5

Where would you look for haemorrhage?

Answer 5

Blood on the floor and four more (chest, abdomen, pelvis, retroperitoneal space, long bones – bilateral femur)

If external haemorrhage - address by applying direct pressure

RUSH (Rapid Ultrasound in Shock) /FAST scan (Focussed Assessment with Sonography in Trauma) - in secondary survey to look for internal haemorrhage

Question 6

Which life-threatening emergencies are you looking for in D of a primary survey?

Answer 6

Intracranial bleed

Raised ICP