The Conduct of

PRIMARY AND SECONDARY

Survey of the Victim
Presented by: GROUP 3
 Emergency Hotlines
A speedy response and immediate
action are crucial in life-threatening
emergencies. Their purpose is to
prevent the situation from getting
worse by maintaining vital functions
and reassuring the patient. Having
emergency hotlines posted in strategic
place in your house is also important.
 What is CPR?
Cardiopulmonary resuscitation (CPR) is a lifesaving technique which is vital
in different emergencies, including heart attack or near drowning, in which
someone’s breathing or heartbeat has stopped.

It is recommended that everyone knows how to begin CPR witch chest

compressions.

In situation like that, it is better to do something than to do nothing at all.

The action you make could be someone else’s life.
 What to do?
Untrained. If you’re not trained in CPR, then provide hands-only CPR. That
means uninterrupted chest compressions at a rate of 100 to 120 per
minute until paramedics arrive (described in more detail below). You don’t
need to try rescue breathing.
Trained and ready to go. If you’re well trained and confident in your ability,
check to see if there is a pulse and breathing. If there is no breathing or a
pulse within 10 seconds, begin chest compressions before giving two
recue breaths.
Trained but rusty. If you’ve previously received CPR training but you’re not
confident in your abilities, then just do chest compressions at a rate of
100.
 Before starting CPR, you must check the following conditions:

Is the environment safe for the person?

Is the person conscious or unconscious?
If the person appears unconscious, tap or shake his/her shoulder and ask
loudly, “Are you OK?”
If the person doesn’t respond and two people are available, have one call 911
or the local emergency number. Get the AED if its available and have the other
person being CPR. AED is an automated external defibrillator. It is a
lightweight, portable device that delivers an electric shock through the chest to
the heart.
 Before starting CPR, you must check the following conditions:

If you are alone and have immediate access to a telephone, call 911 or your
local emergency number before beginning CPR. Get AED, if it is available.
As soon as an AED is available, deliver one shock if instructed by the device,
the begin CPR.
 Difference between:
Signs Symptoms
Signs are details discovered by Symptoms are sensations that the
applying your senses – sight, touch, victim feels or experiences and may
hearing, and smell during the be able to describe.
examination. EX.
EX. Nausea
Bleeding Vomiting
Swelling Heat
Deformities Impaired sensations
 The Conduct of
Primary and
Secondary Survey of
the Victim (CAB)
 Primary Survey
A systematic approach you must do whenever you come across a patient,
regardless of where you find him/her is do a primary survey. Remember the
acronym DRSABCD that describes what you should do first.

Danger. Assure that the area is safe before giving an assistance to the
injured person.

Response. Check if the person is conscious. See if you can get a response
by talking to them, squeezing their hands, or tapping their shoulders. Send
for help. Ask for help or call an ambulance.
 Primary Survey
Send for help. Ask for help or call an ambulance.

Airway. Make sure the airway is clear of obstructions. Open the airway by
tilting the head back with a chin lift.

Breathing. Look, listen, and feel to see if the patient is breathing normally.

CPR. If the patient is not responsive and not breathing (or not breathing
normally), immediately start cardiopulmonary resuscitation by doing 30
compressions followed by two rescue breaths at a rate of 100-120/minute,
or about two/second.
 Primary Survey
Defibrillation. Apply a defibrillator as soon as possible to the patient and
follow the voice prompts. The shock can potentially stop an irregular
heartbeat (arrhythmia) and allow a normal rhythm to restore from a sudden
cardiac arrest (SCA). SCA occurs when the heart malfunctions and stops
beating unexpectedly. If not treated within minutes, it quickly leads to death.
 Secondary Survey
The secondary survey consists of two parts such as visual assessment and
verbal questioning.

1. Visual Assessment 2. Pain Assessment

 Visual Assessment
Head and Face. Inspect for any bleeding and obvious deformity. Check the
ears for blood, fluid, or bruising. Check the eyes for reactivity to light and
equal size pupils. Check the nose for bleeding or deformity. Check the
mouth for missing teeth, clench their teeth (to see if the top meets the
bottom), and anything blocking the airway. Listen to them speaking for any
hoarseness or other abnormalities. Palpate the skull, feeling for any soft
marshy areas.

Neck. Inspect for any bruising, bleeding, or deformity. If you are trained,
palpate for a carotid pulse.
 Visual Assessment
Shoulders and Chest. See fractures, dislocation, cuts or bruises. Examine
the normal palpitation of chest and heart sound. Feel for tenderness and
crepitus. Crepitus is the strange popping sound or crunchy feeling in the
bones, joints, or tissue.

Abdomen. Inspect for cuts, bruises, bleeds, penetrations and impaled

objects. Gently palpate for any tenderness, rigidity or pain.

Pelvis. Inspect for possible injuries or fractures. Feel for tenderness along
the bone, but DO NOT SPRING THE PELVIS. Pushing down on both sides of
the pelvis will make the situation worse if they have a pelvis fracture.
 Visual Assessment
Arms and Legs. Examine for deformities, swellings, bleedings, and
dislocations. Check for joint movements, stability and muscular power.

Back. Feel for tenderness, deformity and other signs of injury. Inspect the
spine and the lower back.
 Pain Assessment
After inspecting and palpating, do the pain assessment. Follow the acronym
OPQRST.

Onset. How has the pain started? What was the patient doing? Was the
patient active or sitting down? Did he/she just have an argument, or going
through a stressful event? Find out whether the pain has come on suddenly,
gradually, or has been a part of a long-term chronic illness/condition.

Provocation. Ask the patient what makes it worse-movement, palpation,

positioning or if it's like that when at rest. You can also ask if there is
anything that makes it better-position, movement, rest.
 Pain Assessment
Quality. Ask either an open-ended question (Can you describe the pain to
me?) or a leading question (Is the pain sharp, dull, crushing, stabbing,
burning, tearing, etc.) Ask if it is constant, intermittent, or comes in waves.

Radiation. Ask the patient to point where the pain originates from. You can
then ask the patient if the pain radiates (extends) anywhere (e.g. chest pain-
does it radiate down the arms, up the neck to the jaw, to the shoulder blades,
to the top of the stomach).
 Pain Assessment
Severity. Ask the patient to describe the pain on a scale of zero to ten, with
zero pain being no pain at all, through to ten being the worst possible pain.
You can ask the patient to compare it to previous injuries or be imaginative
(ten is like getting your arm ripped off). For little kids, it’s hard to determine,
so you can use the Wong-Baker faces scale as an indicator.
 Pain Assessment
Timing. Ask the patient how long it has been going on, if it has changed
since the onset (better, worse, new/different symptoms), if he/she had this
before.

Treatment. This is a good time to ask if the patient has taken any
medication himself/herself or have done anything to help himself/herself
with the pain.
“Health is Wealth.”
- Ralph Emerson