When it comes to accidents and other such traumatic incidents, a concise approach is needed to assess and manage the person’s injuries. The immediate response to an accident is known as basic life support and can be performed by anyone, but advanced trauma life support must be performed by a certified medical practitioner. The main objective of trauma life support is to address the greatest threat to life first.
Trauma life support has three stages primary survey, secondary survey and tertiary survey. A primary survey is the first part of proving trauma life support. This should be addressed in a series of steps that follows the mnemonic, ABCDE.
- Assess the airways: If the person is able to talk, his airways are clear. Hence call out to the person and try to get a verbal response. If the patient is unconscious, make him lie down on the floor with the chin tilted back. Open the mouth and check for any obstructions. Fluids such as blood or vomit that is obstructing the airways may be suctioned out. In case the airway is still obstructed, an endotracheal tube may be inserted.
- Breathing and ventilation: Check for chest movement that may indicate breathing. If present, tracheal deviation and subcutaneous emphysema should be identified. An inspection of the chest can help identify penetrating injuries, bruising, tracheal deviations and a flail chest segment.
- Circulation: Look out for hypovolemic shock that may be caused by excessive bleeding. This bleeding can be controlled by applying direct pressure on the wound. Establish two intravenous lines and administer crystalloid solution to the patient. If the person still does not respond, administer type specific blood or O negative blood to the person.
- Disability assessment: A basic neurological assessment can be made by alerting the person, verbal stimuli and its response or unresponsiveness. Towards the end of the primary survey, the Glasgow coma scale can be used to determine the patient’s level of consciousness.
- Exposure control: While the patient’s clothes will need to be completely removed, protect him from hypothermia by covering him with warm blankets. Warm intravenous fluids before administering them and maintain a warm environment.
Once the patient’s vital signs are turning normal, the medical practitioner can start the secondary survey. This involves a head to toe medical examination and understanding of family medical history. X-rays of the injury sites may also be taken. If at any point, the person’s condition begins to deteriorate, a primary survey should be repeated. As soon as possible, the patient must be shifted off the hard spine board and placed on a firm mattress. This is followed by a tertiary survey, which helps identify injuries that may have been missed earlier and other related problems.