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WHO basic emergency care primary assessment ABCDE airway breathing circulation secondary assessment trauma

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trauma assessment AND secondary survey

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The page asks about patient assessment in an emergency. Here are concise answers:
  1. Main purpose of patient assessment
    To rapidly identify and treat life-threatening problems, stabilize the patient, and identify other injuries or illnesses.
  2. First check during initial assessment
    Check for immediate danger, responsiveness, and catastrophic external bleeding. Then assess airway and cervical-spine protection if trauma is suspected.
  3. ABCDE in primary assessment
    • A - Airway with cervical-spine protection
    • B - Breathing and ventilation
    • C - Circulation, including bleeding control
    • D - Disability, a quick neurological assessment
    • E - Exposure/Environment, expose enough to find injuries while preventing heat loss
    In major trauma, life-threatening external bleeding may be controlled before A, called CABCDE or xABCDE. The WHO emergency-care approach likewise uses a systematic ABCDE assessment.
  4. Why assess the airway immediately?
    An obstructed airway can rapidly cause hypoxia, brain injury, and death. It must be opened and protected first, while avoiding unnecessary neck movement when spinal injury is possible.
  5. How to assess breathing initially
    Look, listen, and feel: observe chest movement, breathing rate and effort, skin color, and wounds; listen for abnormal sounds such as stridor, wheeze, or gurgling; check whether air is moving and whether the patient can speak. Give oxygen or assist ventilation as indicated by trained responders.
  6. Signs of severe external bleeding
    Look for:
    • Spurting or continuous heavy bleeding
    • Rapidly pooling blood or a soaked dressing/clothing
    • Partial or complete limb amputation
    • Signs of shock, such as pale cool skin, weakness, confusion, rapid pulse, or fainting
    Apply firm direct pressure immediately. Use a tourniquet for life-threatening limb bleeding if direct pressure does not control it and you are trained to use one.
  7. Primary versus secondary assessment
    • Primary assessment: a rapid check for immediate threats to life, with treatment done at the same time.
    • Secondary assessment: a detailed examination after urgent problems are controlled, aimed at finding all other significant injuries.
  8. When to perform the secondary examination
    After the primary survey is complete, resuscitation is underway, and immediate life-threatening conditions have been treated. If the patient deteriorates, return to the primary ABCDE assessment.
  9. Information collected in secondary assessment
    Take a focused history, often using AMPLE/SAMPLE:
    • A: Allergies
    • M: Medications
    • P: Past medical history
    • L: Last meal/oral intake
    • E: Events or environment related to the injury
    • Plus symptoms and pain
    Also record vital signs, mechanism of injury, findings from the full examination, and treatment already given.
  10. Why examine head to toe?
    Injuries may be hidden, especially in unconscious, distracted, or multiply injured patients. A systematic head-to-toe examination reduces the chance of missing wounds, fractures, neurological deficits, bleeding, or spinal injuries.
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