Primary Survey - Vocabulary Flashcards

Primary Survey: Quick Reference Notes

  • Purpose: identify and correct life-threatening emergencies in the patient.

  • Time to complete: 2\ \text{minutes} (two-minute primary survey).

  • AVPU and baseline consciousness

    • AVPU: Alert, Verbal, Pain, Unresponsive
    • Acceptable painful stimuli (noxious but non-injurious): earlobe squeeze, trapezius squeeze, nail bed depression

  • Primary survey components (summary of contents and sequence)

    • Introduction and scene assessment: hazard check, don gloves/PPE, determine number of patients, medical or trauma, identify self/offer assistance, tell patient not to move, determine initial AVPU.
    • Airway: open and inspect with penlight; check for obstruction or trauma; ensure patent/clear airway; do not adjust head/neck until C-spine cleared.
    • Cervical spine (C-spine): palpate from base of skull to shoulders; palpate each spinous process for pain/deformity; inspect back of neck for bruising/swelling without moving the neck; after C-spine check, you may position the airway.
    • Breathing: assess by look/listen/feel; determine if breathing is present; assess distress; assess for jugular vein distention (JVD), tracheal deviation, subcutaneous emphysema; assess cyanosis (peripheral and central); perform 4-point auscultation (L apex → R apex → R base → L base).
    • Circulation: palpate carotid pulse (present/strength/regularity); palpate radial pulse (presence suggests systolic BP ≧ 80\ \text{mmHg}); gross bleed check (rapid sweep for hemorrhage).

  • Interventions during the primary survey (priorities before moving to next component)

    • Life-threatening bleed: control hemorrhage immediately before AVPU; apply pressure with gloved hand, then dressing or tourniquet.
    • Unresponsive patient: check carotid pulse immediately; if no pulse, start compressions; if pulse present, assess airway.
    • Airway compromised by blood/vomit: suction immediately.
    • Suspected C-spine injury: provide manual stabilization (usually by partner or fire personnel).
    • Breathing absent: begin ventilations.
    • No pulse: begin chest compressions.
    • Do not perform other interventions during the primary survey until each component is secured.

  • Personal Protective Equipment (PPE)

    • Always wear gloves; consider a mask if patient has SOB, cough, or fever.
    • Don gloves and change as needed during the call.
    • Do not wear gloves while driving.
    • If scene shows coughing/shortness of breath/febrile patient: don N95 mask, eye protection, and disposable gown immediately.

  • Practical execution notes

    • Complete the primary survey within the first 2\ \text{minutes}.
    • If a problem is identified in any component, correct it before moving to the next component.

  • Quick reference recap (from the structured components)

    • Introduction: hazard check, PPE, # of patients, medical/trauma, identify self, offer help, prevent movement, establish AVPU.
    • Airway: open/inspect for obstruction.
    • C-spine: palpate and inspect for injury.
    • Breathing: assess presence, distress, cyanosis, JVD, subcutaneous emphysema; 4-point auscultation.
    • Circulation: carotid and radial pulses; assess for adequate perfusion; perform gross bleed check; monitor SpO2/cardiac status if available.