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The primary and secondary survey represent overarching and sequential The paramedic should initiate a primary and secondary
aspects of patient assessment. Whilst primarily applied in trauma assessment as soon as possible in every case. The collecting
Contraindications
Complications
Figure 3.34
The purpose of a primary survey is to immediately identify and treat life-threatening conditions. The sequencing of the primary survey has
been changed (DRCAB) to bring it in line with contemporary clinical practice.[1] For all other presentations, the primary survey remains DRABC.
RESPONSE Check the patient’s RESPONSE to stimulus to determine level of consciousness. Use the AVPU scale: Is the patient Alert?
Is the patient responding to Verbal stimuli, responding only to Painful stimuli, or Unresponsive? When applying painful stimuli,
CIRCULATION Check if the patient has a pulse (CIRCULATION) and, if so, determine if it is adequate. Assess capillary refill in paediatric
patients. Consider: Defibrillation, haemorrhage control, leg elevation (except for spinal injury), IV/IO access and fluid therapy
AIRWAY Check if the patient has a patent AIRWAY and ensure there is no danger of future airway obstruction (e.g. stridor).
The secondary survey is aimed at obtaining a detailed history, along with vital signs and then performing a focused physical examination
based on the patient’s symptoms and history.
SECONDARY SURVEY
HEAD CHEST
Inspect Inspect Expansion, paradoxical movement, accessory
BACK
Inspect
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