Trauma Assessment - Amplified
Primary Survey (DRABC)
D - Danger
- Environmental hazards
- Personal protective equipment
- Scene safety for team
R - Response
- AVPU: Alert, Voice, Pain, Unresponsive
- Call for help early
A - Airway with C-Spine
Assessment:
- Look: chest rise, foreign bodies
- Listen: stridor, gurgling
- Feel: air movement
C-Spine Protection:
- Manual in-line stabilisation
- Jaw thrust (not head tilt)
- Collar when patient stable
B - Breathing
Life Threats:
- Tension pneumothorax: deviated trachea, absent breath sounds
- Open pneumothorax: sucking chest wound
- Massive haemothorax: dullness to percussion
- Flail chest: paradoxical movement
Management:
- High-flow oxygen
- Needle thoracocentesis for tension
- Chest seal for open pneumo
C - Circulation
Shock Assessment:
- HR, BP (may be normal initially)
- Cap refill, skin colour
- Mental state
Haemorrhage Control:
- Direct pressure
- Elevation
- Tourniquets for uncontrollable limb bleeding
IV Access:
- 2 large bore (16G or larger)
- Bloods including group and hold
- Warm crystalloid (avoid hypothermia)
D - Disability
- GCS (Eye, Verbal, Motor)
- Pupil size and reactivity
- Blood glucose
E - Exposure
- Full exposure, log roll
- Prevent hypothermia (warm blankets, warm fluids)
Special Procedures
Pelvic Binder
Indication: suspected pelvic fracture Level: greater trochanters Technique: one attempt only, tighten until snug
IO Access
Sites:
- Proximal tibia (2cm below tibial tuberosity, medial)
- Humeral head Technique: perpendicular insertion until give Confirmation: aspirate, flush, secure
EFAST
Assess for free fluid in:
- Morison's pouch (RUQ)
- Splenorenal recess (LUQ)
- Pelvis
- Pericardium
- Bilateral lungs (pneumothorax)