How do you carry out a primary survey for an infant?

A primary survey for an unwell infant involves a rapid head-to-toe assessment of their condition, focusing on immediate life-threatening issues and interventions. It consists of the following steps:

1. Check for responsiveness:

* Gently shake the baby and shout, "Are you okay?"

* If unresponsive, shout for help and initiate cardiopulmonary resuscitation (CPR) if necessary.

2. Check breathing:

* Look, listen, and feel for normal respirations for approximately 10 seconds.

* Observe the infant's chest and listen for air movement.

* If the infant is not breathing or gasping, start rescue breathing.

3. Check circulation:

* Look for signs of circulation, such as a palpable brachial pulse.

* Simultaneously feel the brachial pulse and look at a distal pulse (foot or hand) for at least 6 seconds.

* If the brachial pulse is not present or is weak, start chest compressions.

4. Assess airway and provide respiratory support:

* Open the airway using a head-tilt/chin-lift maneuver.

* If an obstruction is suspected, perform a finger sweep of the mouth and pharynx.

* Provide two rescue breaths, watching for chest movement.

* If the first breath does not cause chest movement, ensure the airway is open. Then, give a second breath with more force.

* If rescue breaths are not effective or if the infant's condition worsens, consider using a bag-mask device or endotracheal intubation.

5. Evaluate circulation and provide appropriate interventions:

* If the infant's circulation is not established or is inadequate (pulse is absent or below 60 beats per minute), start chest compressions.

* Initiate CPR based on the infant's size and condition, following the principles of basic life support for infants.

* Continue CPR until the infant begins to breathe or medical help arrives.

6. Control any severe bleeding:

* Use direct pressure to control any obvious bleeding.

* If bleeding cannot be controlled with direct pressure, consider using a pressure dressing or applying a tourniquet.

7. Check for other injuries and conditions:

* Once the infant's airway, breathing, and circulation are stabilized, perform a quick head-to-toe assessment for other injuries or conditions.

* Look for signs of trauma, such as bruises or lacerations.

* Check the infant's temperature and capillary refill time.

* Assess for any neurological signs, such as seizures or posturing.

8. Comfort the infant:

* Once the primary survey is complete and the infant is stabilized, comfort the infant by providing warmth and support.

* Reassure the caregivers and provide ongoing communication about the infant's condition and management.

Remember, a primary survey for an infant should be done quickly and efficiently, focusing on immediate life-threatening conditions and interventions. If the infant's condition is critical or deteriorates at any point, activate the emergency response system and seek advanced medical assistance.