Emergency Scene Management / Primary Survey


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EMERGENCY SCENE MANAGEMENT:

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Secondary Survey:

Follows the primary and any life-saving first aid you have given. This is a step-by-step process of gathering information to form a complete picture of the condition of the casualty. Look for injuries or illnesses that were not revealed in the primary survey, but could benefit from first aid. Do only a secondary survey if there is more than one injury, medical help will be delayed more than about 20 minutes, or you have to transport the casualty.

1) the history of the casualty
2) the vital signs
3) the head-to-toe examination
4) first aid for injuries and illnesses found

Vital signs

The four vital signs show the basic condition of the casualty. Assess the level of each when taking vital signs. i.e. open your eyes, what’s your name? Move your fingers, rate of breathing, etc.

1) level of consciousness
2) pulse
3) breathing
4) skin condition and temperature

How to assess breathing

In primary survey you checked whether or not the casualty was breathing and if the casualty was breathing, whether breathing was effective or ineffective.
In the secondary survey, you assess breathing rate, rhythm and depth, as they are important indicators of a person’s state of health. These signs give early warning of physical changes and of life-threatening conditions

Breathing:

Rate- how many breaths the person takes in one minute breaths per minute is how it’s assessed. Rate is 12 breaths per minute, count the number of inhalations in 30 seconds and multiply by 2.
Rhythm – how regular the intervals between breaths are – rhythm is assessed as either “regular” or “irregular”
Depth – how deeply the person is breathing, assessed as “shallow,” “normal” or “deep”.

Ongoing casualty care

Continue giving first aid to keep the casualty in the best possible condition.

Continue to give casualty care by:

Showing a bystander how to maintain manual support of any injuries, if needed

• Giving first aid for shock, which includes – reassuring the casualty, loosening tight clothing, placing the casualty in the best position for her injuries or illnesses, covering the casualty to preserve body heat and to minimize shock.
• Monitoring the casualty’s condition, i.e. ABC’s
• Giving nothing by mouth, only moistening lips with a wet cloth.
• Recording the casualty’s condition.
• Protecting the casualty’s personal belongings.
• Handing the casualty over to medical help and reporting on the incident, the casualty’s condition and the first aid given.
• Do not leave casualty until medical help arrives.

PRIORITY FROM HIGH TO LOW	CONDITION	EXAMPLES
1st – Airway	- Foreign body blocking airway - Tongue or fluids blocking airway - Swollen airway	- Choking on food - Unconscious, lying on back - Allergic reaction, airway infections
2nd – Breathing	- Injured chest and/or lungs - Brain not controlling breathing properly - Not enough oxygen reaching blood	- Chest injury, broken ribs - Poisoning, drug overdose, stroke, electric shock - Not enough oxygen in air, carbon monoxide poisoning
3rd – Circulation	- Heart not pumping blood - Damage to heart	- Heart Attack, angina, cardiac arrest, cardiovascular emergencies
Injuries that may affect ABC’s (above) or have potential for life-long disability	- Severe bleeding - Fractures that could affect breathing - Fractures – open, sever or multiple bones - Head/spinal injuries - Critical burns	- Amputations, chest wounds, internal bleeding - Broken ribs, shoulder blade - Broken upper leg, pelvis, crushed arm - Fall from a 6 foot ladder 3rd degree burns to the hands
Minor injuries	- Minor fractures - Minor bleeding - Non-critical burns - Behavioral problems	- Broken lower leg, lower arm, hand, finger, etc. - Bleeding not spurting or free-flowing - 2nd degree burns to the forearms Grief or panic

IMPORTANT NOTICE:

The information contained in this document has been compiled from sources believed to be reliable at the time and is presented here as a study aid and for general information use only. This information is not intended to replace or supercede the information or procedures outlined in your first aid textbook, other officially issued study materials or government published acts or legislative documents.
Whilst every effort has been made to ensure that the information is accurate at the time of publication, the authors are not responsible for any loss, liability, damage or injury that may be suffered or incurred by any person in connection with the information contained on this site, or by anyone who receives first aid treatment from a reader or user of this information.