Trauma Assessment

Primary Survey (DRABC)

D - Danger

• Scene safe for self and team

R - Response

• AVPU scale
• Call for help

A - Airway + C-Spine

• Manual in-line stabilisation
• Jaw thrust (not head tilt)
• Suction, OPA/NPA

B - Breathing

• Expose chest
• Look, listen, feel
• SpO2, high-flow O2

Life threats: Tension pneumo, open pneumo, massive haemothorax, flail chest

C - Circulation

• Control external bleeding (direct pressure)
• 2 large bore IV
• Bloods + crossmatch
• Warm fluids if shocked

Pelvic Binder

• Apply at level of greater trochanters
• One attempt only

<Diagram src="/figures/trauma/pelvic-binder-correct.jpg" alt="Correct pelvic binder placement" caption="Pelvic binder at greater trochanter level" />

D - Disability

• GCS
• Pupils
• Glucose

E - Exposure

• Fully expose, log roll
• Prevent hypothermia

IO Access

• Site: proximal tibia (2cm below tibial tuberosity)
• Alternative: humeral head
• Insert perpendicular until give
• Aspirate, flush, infuse