PRIMARY SURVEY

This document outlines the steps and considerations for conducting a primary survey in injury evaluation, emphasizing the importance of scene safety, patient consent, and identifying life-threatening conditions. It covers the essential components of the primary survey (Airway, Breathing, Circulation, Deadly Bleeds, and Shock) and secondary survey, including how to manage various scenarios such as unconscious patients, obstructed airways, and different types of shock. Special attention is given to communicating with special populations like children and the elderly, and determining when and how to activate emergency medical services (EMS).

Initial Steps and Consent

Phases of Injury Evaluation: The evaluation process is divided into on-field (acute care with primary and secondary surveys) and off-field assessments, with the latter allowing for more in-depth analysis.

Consent: Obtaining consent is mandatory before providing any care, with unconsciousness implying consent. For minors, consent must come from both the minor and a parent, who should be contacted ASAP.

Primary Survey: ABCDs

Scene Safety: Assess the safety of the scene, considering factors like the sport being played, environmental hazards, and potential mechanisms of injury.

ABCDs: The primary survey focuses on identifying and addressing life-threatening injuries:

  • Airway: Ensure the airway is open and clear. Equipment removal.

  • Breathing: Assess the quality and quantity of breathing. Obstructed airway, choking on things.

  • Circulation: Check the pulse rate and quality. Using AED.

  • Deadly Bleed: Identify and control any profuse bleeding. Venous, ARterial, Vapillary.

  • Shock:

Unconscious Patient: In an unconscious patient, prioritize opening the airway, checking for breathing (look, listen, and feel for no more than 10 seconds), and assessing circulation by checking the carotid artery in adults/children or the brachial artery in infants.

Secondary Survey and Special Conditions

Secondary Survey: Conducted if the primary survey reveals no immediate life-threatening injuries, involving a more detailed evaluation of the injury and the patient's condition.

Breathing: Address obstructed airways using abdominal thrusts (Heimlich maneuver) and back blows, especially if the person is choking.

Deadly Bleeds: Control severe external bleeding through elevation, direct pressure, pressure points, hemostatic agents, or a tourniquet. Internal bleeding is harder to detect but requires close monitoring.

Shock: Manage shock by activating EMS, maintaining body temperature, elevating feet and legs, keeping the patient calm, and restricting food or drink. Recognize the signs and symptoms of shock, such as pale, cool, clammy skin, a weak and rapid pulse, and quick, shallow respiration.

When to Call

When to Call: It is important to know when to call emergency services, such as in cases of unconsciousness, trouble breathing, severe bleeding, chest discomfort, or injuries to the head, neck, or back.

Important Information: When calling 911, provide the type of emergency, number of people involved, what happened, type of injury, present condition of the victim, current care provided, and the exact address and directions to the site.