Primary Survey in Health Assessment

Introduction to Health Assessment - The Primary Survey

Overview

  • This presentation covers the primary survey in health assessment (NSB103), emphasizing its importance in identifying and addressing immediate life threats.

Acknowledgment of Traditional Owners

  • QUT acknowledges the Turrbal and Yugara people as the First Nations owners of the lands where QUT stands.
  • Respect is paid to their Elders, lores, customs, and creation spirits.
  • The lands have always been places of teaching, research, and learning.
  • Acknowledgment of the important role Aboriginal and Torres Strait Islander people play within the QUT community.

Learning Outcomes

  • Identify the importance of a structured nursing assessment.
  • Apply the primary survey to patient assessment across the lifespan.
  • Identify and relate vital signs to the primary survey.
  • Consider the primary survey within the context of the Clinical Reasoning Cycle.

Recommended Reading

  • Chapter 16 of Potter & Perry’s Fundamentals of Nursing - ANZ edition: Vital signs: Using a primary survey approach for patient assessment.

The Importance of Structured Nursing Assessment

  • The primary survey forms the basis of clinical assessment in every patient encounter.
  • Clinical assessment allows the nurse to:
    • Identify abnormal findings.
    • Detect clinical deterioration.
    • Feed information into the clinical reasoning cycle to plan care.
  • When clinical assessment fails, patients are put at risk.

What is a Primary Survey?

  • Primary surveys are used to rapidly identify potential or actual life threats that require immediate intervention.

Core Physical Assessment

  • The primary survey's core physical assessment is arranged in a specific order of performance.

Danger

  • Prioritize safety and be aware of potential hazards before approaching the patient.

The Airway

  • Assessing and managing the patient's airway is a critical component of the primary survey.

Breathing

  • Breathing assessment is defined by five areas of nursing assessment:
    • Respiratory rate
    • Depth of respirations
    • Patterns of respiration
    • Lung sounds
    • Oxygenation

Circulation

  • Assessment of the patient's circulatory status, including pulse and blood pressure.

Disability

  • Assessing the patient's level of consciousness using the AVPU scale:
    • A - Awake: Patient is awake.
    • V - Verbal: Patient responds to a verbal stimulus.
    • P - Pain: Patient responds to a pain stimulus.
    • U - Unresponsive: Patient is unresponsive to any stimulus.

Disability - Pain

  • "Pain is whatever the experiencing person says it is, existing whenever he says it does" – Margo McCaffery (1968).
  • Pain is subjective; therefore, the only person who can tell how much pain they are in is the person experiencing the pain.
  • Assess for pain in a manner that is appropriate for the patient in front of you, believe them, and act upon it.

Exposure

  • Expose the patient to assess for any obvious injuries or conditions, while also preventing heat loss.

Summary

  • Primary assessment identifies immediate life-threatening alterations in function.
  • It forms the basis of clinical assessment for all of our patients.
  • Primary assessment feeds information into the first three stages of the clinical reasoning cycle.