In the initial assessment and primary survey, the recognition and treatment of life-threatening injuries follow a

systematic approach.

Primary Survey:
1. Airway: Apply cercical collar and assess the airway for any obstructions and make sure airway is open and not
compromised. If an obstruction is present, clear it immediately. Open airway with jaw thrust technique and place
airway adjunct such as OPA and continue bagging with BVM. Call for help and prepare for intubation if GCS < 8.

2. Breathing: Access the patient's breathing. If breathing is compromised or absent, initiate rescue breathing or
cardiopulmonary resuscitation (CPR) as needed. Assess the patient breathing rate and pattern, look for any sign of
distress and observe for any abnormal chest movement. Treat any tension pneumothorax, flail chest, or other
conditions that may compromise breathing.

3. Circulation: Check the patient's circulation, including assessment of the pulse and skin color. Control external
bleeding using direct pressure, elevation, or tourniquets. Insert two large bore branula access for fluid resuscitation
and medication.

4. Disability: Assess the neurological status of the patient, including assessing for consciousness, pupil reaction,
motor responses and look for signs of head injury. Stabilize the patient cervical spine if there is suspicion of spinal
injury.

5. Exposure/Environment: log roll and expose the patient to evaluate for any hidden injuries or signs of
hypothermia. Maintain a warm and supportive environment.

Secondary Survey:
Once the primary survey is completed and any life-threatening injuries are addressed, the secondary survey is
performed to identify potential life-threatening injuries and provide appropriate care. This includes:

1. Head-to-toe examination: Conduct assessment of the patient entire body to identify any injuries or abnormalities.
This may involve conducting physical examinations, obtaining imaging studies, or ordering laboratory tests as
necessary.

2. History taking – SAMPLE method

3. Specialist consultation: Consult with specialists or appropriate healthcare professionals to guide the evaluation
and treatment of specific injuries or conditions.