Preliminary assessment (primary survey)

Airway
Protect cervical spine, if injury possible. Assessment: any signs of obstruction? Ascertain patency Management: establish a patent airway.

Breathing
Assessment: determine respiratory rate, check bilateral chest movement, percuss and auscultate. Management: if no respiratory effort, treat as arrest2 (see inside back cover), intubate and ventilate. If breathing compromised, give high concentration O2, manage according to findings, eg relieve tension pneumothorax.

Circulation
Assessment: check pulse and BP; is he peripherally shut-down?; check capillary refill; look for evidence of haemorrhage. Management:


•
if no cardiac output, treat as arrest


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if shocked, treat as shock

Disability
Assess "˜level of consciousness" with AVPU score (alert? responds to voice? to pain? unresponsive?); check pupils: size, equality, reactions. Glasgow Coma scale, if time allows.

Exposure
Undress patient, but cover to avoid hypothermia.