Primary Survey

GO DR SHAVPU

Gloves On

Danger - Is there any danger to yourself or others? Use your common sense, If you feel unsure for any reason then call for the relevant help. click here

Response - Is the patient responding

Scene History - What has happened? Are there any clues relevant to the situation. Empty drug packets, empty bottles of booze. How is the patient found, are they unconscious on ground or slumped in a chair, sitting, standing? Are there any other people around? If so does Danger (above) apply?

Patients Level of Consciousness - Is the Patient,
Alert - Patient fully conscious and responds normally
Verbal - Responds to voice. Hello! Open your eyes!
Pain - Responds to pain stimuli. Pinch earlobe, Pressure applied to the patients nail bed
Unconscious - No Response to any stimuli.

THEN go on to the following:

ABC
Airway - Check that airway is clear.

Breathing - Head tilt, chin lift. Look, Listen and Feel for 10 seconds. If not breathing insert Oropharyngeal or Nasopharyngeal airway.

Circulation - Start CPR

Some of you may be saying "But you forgot the pre-cordial thump!" or "What about C Spine injury?" " Wouldn't you whip out your laryngoscope and intubate?" Well your right, but I didn't forget them. This is aimed at Community Responders, not Paramedics, A&E Doctors or even Wilderness Medics like myself. All of which will do things differently. What I have to be careful of is not doing something that I shouldn't be doing in the situation I'm in. Confused? Good, so am I!

Let me try and explain.

If I'm in the jungle in Borneo and someone needs an emergency tracheostomy, then they'll get one. If I'm at 7000m in the Himalayas and I need to set a broken femur then I will. If however I'm at number 10 Anyold Street somewhere in Berkshire, then all the patient/casualty is going to get is what the Ambulance Service say they can get from a Community Responder. THAT is why I left out things like thumping people on the chest. Got that? Clear as mud? Cool!

Anyway, hope the above helps!

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