Primary & Secondary Survey of a Trauma Patient

Traumatic injury is the leading cause of death for individuals under the age of 44. Because of trauma's widespread occurrence and urgent nature, doctors have developed a method for assessing and correcting the trauma victims most urgent needs first. Once these have been taken care of, doctors and nurses can focus on the patient's less immediate concerns.

ABCDEF

• During the primary survey, hospital or emergency-relief workers quickly assess the areas of the patient's health that are most crucial to life. These are most commonly referred to using the acronym "A B C D E." Some hospitals include an "F." This list includes the airway, breathing, circulation, disability, environment and (sometimes) full vitals.

Airway, Breathing and Circulation

• Emergency room workers begin by checking to see if air can move freely from the mouth to the lungs. If it cannot, doctors must remove the obstruction or perform a tracheotomy. Next, they observe the patient's ability to breathe independently, which may be affected by the function of the lungs and the chest wall stability. When the breathing is under control, doctors move to examining the patient's heart function and check for any external causes of hemorrhaging. Surgery or other treatment may be necessary to address these concerns.

Disability, Environment and Full Vitals

• Emergency room workers assess the patient for obvious disabilities by testing motor skills and performing a mental status test. If spinal injuries are present, they are treated during this step. Next, the patient is undressed and examined, covered with blankets and given intravenous fluids to prevent hypothermia. Once these steps have been completed, the patients vitals are checked to ensure stability.

AMPLE History

• Once the patient is stable, doctors move to the secondary survey. During this survey (represented by the mnemonic AMPLE) health care professionals gain a more thorough understanding of the patient's medical history and the events of the accident. Comprehensive care staff ask about allergies the patient has, along with medications the patient is taking, and the time of the patient's last meal.

Event and Examination

• Doctors talk to the patient about the events surrounding the traumatic event, including details about the events and how they happened. Many times, the patient provides information important to the treatment that follows. After the AMPLE history is taken, the doctor performs a thorough physical examination of the head, neck, chest, abdomen, pelvic area, arms, legs and spine. A full mental status examination often follows.