Here Are Accident Primary Survey Details That Ensures Survival

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When accident occurs, rescuers usually rush in rescuing victims. Care should be taken to ensure the safety of yourself, the victim and environment, in as much as delay is dangerous. Hence the need to conduct an accident primary survey. Primary survey simply means a systematic and orderly way of pre-hospital assessment of casualties to rapidly ascertain their conditions and make appropriate interventions

Processes Of Accident Primary Survey

The following are the processes involved in primary survey

  • Assessment
  • Intervention
  • Re-assessment

The Acronyms A, B, C, D Of An Accident Victim

The scene guide is this acronyms A, B, C, D

  • A – Airway
  • B – Breathing
  • C – Circulation
  • D – Disability This is expected to be done within 60-90 Seconds
Accident victim receiving attention

key learning points

  • a) Safety Your safety Scene Safety Casualty Safety Note: Do not be a casualty yourself when you are out to rescue a casualty
  • b) To detect time critical and potentially critical patients
  • c) Systematically and orderly
  • d) Do not be anxious to prevent missing out any important life threatening conditions

Airway

  • Maintain an adequate open airway . This is the main foundation of all casualty management
  • Look, listen and feel

Assess

  • Vocalisations
  • Obstruction
  • Causes of airway obstruction- tongue, – foreign body blood, secretions, oedema, – laryngeal spasm

Interventions

  • Suction if there are secretions in the airway
  • Open airway
  • Head tilt, chin lift (not used in cervical spinal injury)
  • Jaw thrust is used in cervical spinal injury
  • Oro/Nasopharyngeal airway (airway Adjuncts). Nasopharyngeal airway is not used in fractures of the base of the skull
  • Maintain neutral alignment of cervical spine (support head and neck)

Re-assess

  • Airway is clear

Breathing

Assess

  • Rate and depth of respiration
  • Rise and fall of chest wall symmetry
  • Use of accessory muscles
  • Cyanosis
  • Open chest wound

Intervention

  • Oxygen
  • Nonrebreathing mask
  • Bag-valve-mask(BVM)
  • mechanical ventilators
  • Seal the open chest wound

Re-assess

  • Ensure interventions have been effective

Circulation

Assess

  • Major pulse
  • Carotid pulse: rate volume/Rhythm
  • Radial pulse(indication of BP)
  • External Bleeding
  • Skin colour – pale
  • Skin texture- sweating

Intervention

  • Control bleeding (clean and apply direct pressure/ dressing pack)

Re-assess

  • Ensure interventions have been effective

Disability

Assess

  • Level of response
  • A – alert
  • V – response to verbal communication
  • P – response to pain
  • U – unresponsive
  • Pupils
  • Equality
  • Reaction to light- swift/ moderate / Sluggish
  • Slow to reactions
  • Blood – Glucose level

Intervention

  • Intubate if GCS is <8
  • Give Glucose level

Reassess

  • Ensure interventions have been effective
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