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SECONDARY SURVEY
T : TENSION PNEUMOTHORAX
M : MASSIVE HEAMOTHORAX
F : FLAIL CHEST
C : CARDIAC TAMPONADE
IMPORTANT COMPONENTS IN
PRIMARY SURVEY
1) General impression of the patient :
help us to decide the seriousness of the patients condition.
2) Assess the patients mental status :
o determine if the patient is responsive or unresponsive.
o clasify the patient by AVPU scale.
o A ( ALERT ) - Patient will be awake, responsive, oriented and
talking with us.
o V ( VERBAL ) - Patient who appears to be unresponsive at
first, but will respond to a loud verbal stimulus from us. The
patient may speak, groun, grunt, or simply look at us.
o P ( PAINFUL ) If theres no respond to verbal stimuli, patient
may respond to painful stimuli such a sternal ( breastbone ) rub
or a gentle pinch to the shoulder.
o U ( UNRESPONSIVE ) Patient does not respond to any
stimuli.
3) Remember the steps of DR ABCD.
o D ( DANGER ) : make sure that everyone are in safe
condition ( you, victim & any bystanders ).
o R ( RESPONSIVENESS ) : tap the victim shoulder and
ask him / her loudly sir/madam, are you okay? Ifs
theres no respond from the victim, try to find out what
is wrong with him / her. Shout for help and get someone
to call for ambulance ( 999 ). Look for no breathing or
only gasping almost simultaneously before activating
the response system. Put him / her in supine position
and initiate CPR.
o A ( AIRWAY ) : make sure that patients airway always
open and not obstruct ( FB / Floppy tongue ). Open the
airway by using 2 technique which are Head Tilt Chin
Lift ( not suspected spine injury ) and Jaw Thrust
( patient suspected with spine injury ).
oB ( BREATHING ) : Assess the patients
breathing by Look ( chest movement ), Listen
( quality of breath sounds ) and Feel ( the
presence of exhaled air ).
C ( CIRCULATION ) : check the pulse
i. S ( SIGN / SYMPTOMS )
ii. A ( ALLERGIES )
iii. M ( MEDICATIONS )
OR INJURY )
2) Rapid assessment : quick assessment
especially for a critical patient. Head to
toe examinations :
Head & neck : check if theres any
feces.
Legs : try to find out any
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