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  1. What is a Primary Survey?
    • A= Airway with cervical spine (always together)
    • B= Breathing
    • C= Circulation
    • D= Disability
  2. Mandated Reporting of:
    • Any death in ER
    • Child abuse
    • HIV, hepatitis, TB,
    • Abuse of disabled adults, elder abuse
    • Elopement of psych patient
    • Extensive burns, gunshot wounds, stab wounds, Homicide
    • Infectious outbreaks, Internal disaster, Sexual aassault, STD, suicide
  3. Triage:
    • Sorts patients accodring to severity of health problem and immediacy of treatment required.
    • Patients with threat to life, vision, or Limb are treated before other patients
  4. Life threatening Conditions identified during primary survey
    • Airway- inhalation, obstruction, penetrating wounds.
    • Breathing- Anaphylazis, flail chest, hemothorax, pnuomothorax (open or tension)
    • Circulation- Direct cardiac injury (MI or trauma), tamponade, shock (hypovolemic or burns), hemorrhage
    • Disability - AVPU head injury or stroke
  5. S/s of airway compromised:
    Dyspnea, inability to vocalize, presence of foreign body, face or neck trauma
  6. Maintain Airway by:
    Jaw thrust maneuver, suction &/or remove foreign body, nasopharyngeal or oral airway, endotracheal intubation
  7. S/s of breathing compromised:
    Dyspnea, paradoxic/asymmetric chest wall movement, decreased/abscent breath sounds, Chest wall trauma, tachycardia, hypotension
  8. Support for breathing problems
    High flow O2, bag-valve-mask ventilation with 100% o2. intubation for life-threatening conditions, cricothyrotomy or tracheostomy
  9. S/s of circulation compromised:
    Check central pulse, assess skin color, temp, moisture, assess mental status and capillary refill
  10. Support for Circulation:
    2-large bore IVs, aggressive fluid resuscitaion, normal saline or lactated ringers, blood or blood products
  11. If disability is present:
    • Pts LOC,
    • A=Alert
    • V=response to voice
    • P=Response to pain
    • U= unresponsive
    • Glascow coma scale, pupils (size, shape, response to light, equality)
  12. AVPU
    • A=alert
    • V=verbal stimuli
    • P=Painful Stimuli
    • U= unresponsive
  13. Secondary Survey
    • Brief systematic process to identify all injuries
    • undertaken after completion of primary survey
    • undertaken when life-threatening injuries have been stabilized
  14. E
    • E- exposure/environmental control
    • F- Full VS/5 interventions/Facilitate family presence
    • G- Give comfort measures
    • H-History/Head to toe assessment (AMPLE)
    • I-inspect posterior surfaces
  15. Five interventions:
    EKG, Pulse OX, Indewelling Cath (core temp) NGT or OGT (blood in Stomach), Blood studies ( sugar, alcohol, electroylytes, liver and cardiac enzymes, pregnancy test)
Card Set:
2011-10-16 05:14:29
Trauma ED med

test 3
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