Pathophysiology
Clinical meaning
The Primary Survey is a rapid, systematic assessment approach used in trauma and emergency situations to identify and immediately treat life-threatening conditions. It follows the ABCDE framework, addressing threats to life in order of priority. Each step must be assessed and managed BEFORE moving to the next: you cannot assess breathing if the airway is compromised. A: Airway (with C-spine protection): • Is the airway patent? Look for obstruction (tongue, blood, vomit, foreign body, edema) • Listen for stridor, gurgling, snoring (signs of partial obstruction) • If trauma suspected: Maintain c-spine immobilization with jaw thrust (NOT head-tilt chin-lift) • Interventions: Suction, oral/nasal airway, intubation if needed B: Breathing: • Is the patient breathing? Rate, depth, rhythm, symmetry, effort • Expose the chest: look for tracheal deviation, JVD, flail chest, open wounds • Auscultate bilaterally: absent/diminished breath sounds? • SpO2 monitoring • Life threats: Tension pneumothorax, open pneumothorax, massive hemothorax, flail chest • Interventions: O2, needle decompression, chest seal, intubation C: Circulation: • Is there a pulse? Rate, quality, regularity • Signs of shock: Tachycardia, hypotension, cool/pale/diaphoretic skin, delayed cap refill...