Primary Survey

Elements used in the managemetn of haemorrhage (left to right, top to bottom): Belmont rapid infuser, EZ-IO intraosseous cannulation device, combat application tourniquette (CAT), haemostatic gauze, positive FAST ultrasound view of the LUQ (http://www.sonosite.com/education).

About the podcast

This edition of ThePTN podcast brings us back to the basics of trauma assessment; the primary (and then secondary) survey(s)! Introduced into everyday practice in Advanced Trauma Life Support course (ATLS) in the late 80’s, the primary survey gives us our structure for assessing trauma patients. Prof Jason Smith, consultant in Emergency Medicine gives us his insight and experience on the primary survey

Jason reflects on the ‘classic teaching’ of the primary survey and how this is put into practice. He then moves onto differentiating the function of the primary survey based on the patient in front of you; the ‘traditional’ big-sick patient who needs immediate, time critical intervention to save their life vs. the physiologically stable injured patient who requires systematic, structured assessment. We also touch on the secondary survey in trauma.

This is a huge topic and these is a lot of overlap across all our podcasts. Be sure to check them all for more a more in-depth cover. Check the show notes for the learning areas for the level 1 and 2 Major Trauma Nursing competencies covered in this podcast, along with other useful resources.

The Primary Survey – ThePTN podcast

Prof Jason Smith joins the podcast in this episode. We cover what 'traditional teaching' classifies as the primary survey and reflects on how this has changed over time. Discussions centre on how some of these traditional elements may not be relevant and how we might change how we make use of the primary survey itself depending on the patient in front of you.

Learning areas in this podcast:

  • Demonstrate how to assess the airway in the trauma patient
  • Has underpinning knowledge of anatomy and physiology of the airway
  • Is able to show knowledge of anatomy and physiology of the respiratory system
  • Needle decompression
  • Thoracostomy: Understands the indications and can set up for thoracostomy and is able to check the equipment appropriately
  • The nurse AHP can demonstrates an understanding of the principals of secondary survey
  • The nurse/AHP understands that secondary survey may not be performed prior to transfer
  • The nurse AHP can assist in carrying out a secondary survey

Links:
Peninsula Trauma Network (PTN) Major Trauma Network guidance, Standard Operating Procedures (SOPs) here.

ThePTN videocast on radiology primary survey here.

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