ABC Primary Survey

ABCDE Primary Survey

Assume C-spine inujury
immobilize c-spine with collar or sand bags

Airway Assessment

1) Assess ability to speak
2) Dysphonia
3) LOC
4) Ability to breathe
5) Apnea
6) Noisy breathing
7) Respiratory distress
8) Extra sounds
9) Cyanosis
10) Choking sign
11) Look for causes of airway obstruction
12) Look inside mouth
13) Look for facial and neck trauma

Jaw thrust to open airway. Suction secretions which may be obstructing airway.
If airway compromised, secure with NP airway.
Continously reassess airway.

Breathing Assessment

Assess respiratory rate

Would obtain:
O2 saturation, pulse oxymetry
ABG
CXR

Look at:

Mental status and for agitation
Movement of chest (flail segments)
Accessory muscle use
Colour (cyanosis)

Listen for:
Sounds of airway obstruction, such as stridor
Breath sounds
Air entry, is it symmetrical
Air escaping

Palpate:
Trachea (for shift)
Chest wall for crepitus
Subcutaneous emphysema
Flail segments
Sucking chest wounds
Chest percussion

If breathing is compromised, give nasal prongs, venture mask, bag-valve mask and ventilate.

Circulation Assessment:

Assess pulse rate and quality (strength)
Obtain blood pressure and pulse pressure

Assess capillary refill
Skin colour
Ask about urinary output estimation
Stop any major external bleeding

Insert 2 peripheral large bore IVs
If difficult, obtain a central IV

Disability Assessment

Assess LOC by avpu:
Alert
Responds to Verbal stimuli
Responds to pain
Is Unresponsive

Assess pupils for:
Size
Reactivity
Extremity movement

Exposure Assessment

Expose patient entirely
Keep patient warm

Orders

General - ask for vitals q5-15 minutes

Do an EKG, FAST (U/S abdomen)

Monitors (BP, pulse oximetry)
Foley catheter
NG tube

Order: CBC, lytes, BUN, Cr, Glucose, Coags., Cross and Type,
hCG, Tox screen, LFTs, Amylase