Primary Trauma Survey

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Primary Trauma Survey: 

Aries Glenn B. Galao , BSN, RN Primary Trauma Survey

Airway management and cervical spine immobilization: 

Airway management and cervical spine immobilization

PowerPoint Presentation: 

Open airway using the jaw-thrust method. Assess airway for compromise and/or obstruction Suction nasal/oral pharynx to clear blood, secretions, or debris

Breathing and ventilation: 

Breathing and ventilation

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Assess respirations for: Rate, depth, quality, effort Inspect and palpate chest Auscultate lung fields for diminished or absent breath sounds if ventilation is abnormal Manually ventilate with BVM if breathing is absent or inadequate

Circulation and hemorrhage control: 

Circulation and hemorrhage control

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Assess pulse for: Presence, quality, regularity Begin chest compression if no pulse can be detected Assess: Skin color , temperature, moisture, capillary refill Control hemorrhage with direct pressure

disability: 

disability

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Determine and establish a baseline GCS (Glasgow Coma Scale) Score May use AVPU Assess pupils PERRLA (Pupils Equal and Round, Reactive to Light and Accomodation )

Expose/environment: 

Expose/environment

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Remove clothing Assess entire patient for injury and hemorrhage Maintain body temperature by keeping the patient covered

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Log roll to inspect and palpate posterior surfaces Immobilize entire body Use a c-spine collar and long board

Special considerations: 

Special considerations

IV Fluids and Blood: 

IV Fluids and Blood LR is the fluid of choice in trauma patients CAUTION: LR contains calcium which causes donor blood to clot in the IV tubing If a blood transfusion is likely, then NS is the fluid of choice

Pregnancy : 

Pregnancy Cervical spine immobilization Pregnant women (> 24wk ) should be immobilized in the left lateral position if possible to avoid compression of the vena cava, which causes supine hypotension

Mechanisms of injury: 

Mechanisms of injury

Motor Vehicle Accidents (MVA): 

Motor Vehicle Accidents ( MVA ) Direction of impact Speed at impact Condition of vehicle Use of seatbelts or airbags Ejection from vehicle Was any other passenger from the same vehicle killed Delayed transport due to extrication from vehicle Chest or abdominal bruising from steering wheel or seatbelt

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Falls From what height Onto what type of surface Penetrating Trauma Weapon Site and depth of injury Underlying organs Weapon-patient distance Caliber and velocity of bullet

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Burns Degree of burns % total body surface area ( TBSA ) Associated trauma

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Revised Trauma Score ( RTS ) Component Finding Value Respiratory Rate 10-29/min 4 >29/min 3 6-9/min 2 1-5/min 1 Apnea 0 Systolic Blood Pressure >89 4 76-89 3 50-75 2 1-49 1 Pulseless 0 Glasgow Coma Scale Score 13-15 4 9-12 3 6-8 2 4-5 1 0-3 0

Thank You!: 

Thank You!