C ASUALTY A SSESSMENT (P RIMARY AND S ECONDARY S URVEY ) N OTE : NOTES BASED ON NON MASS - CAT SITUATIONS Prepared By: Corps SO(5) Wilson Cheng Wei Sheng

CASUALTY ASSESSMENT (PRIMARY AND SECONDARY SURVEY)

NOTE: NOTES BASED ON NON MASS-CAT SITUATIONS

Prepared By:

Corps SO(5) Wilson Cheng Wei Sheng

Clementi Town Corps

Corps Liason Officer

Last Updated: 12 August 2010

BY THE END OF TODAY……

Perform Casualty Assessment Primary Survey Secondary Survey

Perform Handover to Paramedics

WHAT SHOULD I DO?

GENERAL SITUATION

5 Simple Steps:

Step 1: Assess The Environment

Step 2: Assess Casualty’s Condition

Step 3: Determine and Perform Necessary

Treatment

Step 4: Maintain and Monitor Casualty’s

Condition

Step 5: Hand-over to Paramedic

GENERAL SITUATION

5 Simple Steps:




Treatment


Condition


STEP 1: ASSESS THE ENVIRONMENT

DANGERIs it safe for you to

approach?

NoIs hazard removable/

Avoidable?

YesProceed to Step 2.

NoCan Casualty be moved to

safety?

YesRemove/Avoid hazard and

proceed to Step 2.

NoCall for Ambulance and wait

for Paramedics

YesMove Casualty and proceed

to Step 2

Safety is important: The Worst kind of First Aider is a dead one.

WARNING: WHEN NOT TO MOVE CASUALTY

Complains of pain to the neck or spine

Has gone through a very high impact trauma or

accident

Has been flung or thrown off a distance

Has a serious head injury

Has been pinned under a heavy object for over an

hour

BUT……

If there is immediate danger to the casualty or first aider’s life, where the situation cannot be eliminated or controlled:

MOVE THE CASUALTY!!!

Even if casualty suffers from the above mentioned situation.

CASE STUDY 1

CASE STUDY 2

CASE STUDY 3

GENERAL SITUATION

5 Simple Steps:




Treatment


Condition


STEP 2: ASSESS CASUALTY’S CONDITION

Assess Steps: Check Level of Conscious Check Upper Spine Check ABC Head to Toe Body Survey Skin If possible, put casualty to recovery / sitting

position

STEP 2: ACCESS CASUALTY’S CONDITION Approach Casualty carefully and approach him/her

from his/her feet direction first Determine Casualty’s level of conscious (AVPU)

Gently tap the shoulders of the casualty and ask “Hello Hello, Are you ok?”

Casualty Response No Response

•Proceed to check neck, ABC and perform CPR if necessary.

•If there is two first aiders is present, the other FA is to perform primary survey co-currently (Bottom-up approach).

•Ask Casualty where he/she feels pain/discomfort

•Comfort the Casualty

•Inform Casualty that you will check for injuries and perform primary survey

•If there is two first aiders is present, the other FA is to treat any visible injuries first.

STEP 2: ASSESS CASUALTY’S CONDITIONPRIMARY SURVEY

Head to Toe assessment to locate any injuries (especially non-visible injuries) and allow necessary treatment to be performed early.

Assessment should be quick ( between 30 seconds to 2 minutes)

Assessment uses your senses ( Touch, Sight, hearing and smell)

If casualty is conscious, casualty is able to assist you by responding to you if he/she feels any sensations.


Upper Spine survey Run your fingers gently along the spine from the

base of the skull and move downwards as far as possible without disturbing the casualty’s position

Check for: Irregularity Swelling Tenderness

Loosen Clothing around neck, belt, take off shoe and socks, remove all hard objects in pockets and look for medical warning bracelets or stoma in the windpipe


Check ABC Airway

Any obstructions? Any dentures? Any burn marks/wounds on lips or in mouth?

Breath Rate, depth and nature (easy or difficult, noisy or quiet) Does chest expands evenly, easily and equally on both

sides? Circulation

Pulse per minute, nature (quick or slow, deep or shallow)

Note: Proceed with CPR if ABC not present


Head Run hand carefully over scalp.

Look for – Bleeding, Swelling or Depressions If casualty is conscious, speak to each side of the

ear to determine if casualty can respond. Look for blood or clear fluid oozing out for either ear

Check if eyes are open: Check size of pupils Any foreign objects, bloody or bruising in the white of

the eyes. Check nose:

Any discharge


Body Feel along both collar bones and shoulders :

Deformity, Irregularity or Tenderness Feel along ribcage:

Deformity, Irregularity or Tenderness Grating sound/unusual when breathing Any bleeding

Check Movement for arms, elbows, wrists and fingers : Run your hand downs each arm (using one arm as

reference to the other) Deformity, Irregularity or Tenderness Any Bleeding

Bend and straighten arm and hands Check Circulation on each fingers


Body Lower Spine

If there is any impairment in movement or loss of sensation in limbs, do not move casualty to examine the spine.

If not, gently pass your hand under the hollow of the back and feel along the spine Check for swelling or tenderness

Abdomen Gently feel for any bleeding, rigidity or tenderness of

the abdomen muscular wall.


Lower body Feel both sides of the hips. Gently try rocking the

pelvis to feel for signs of fracture. check if any bleeding or incontinence

Use both hands and feel the entire length of leg. If casualty is conscious and alert, ask casualty to assist

you by moving ankles and knees Look and feel for any bleeding, swelling, deformity or

tenderness Check circulation for each toes


Skin Color, temperature and state of skin

Is it pale, flushed or grey-blue? Is it hot or cold, dry or damp? Is it blue? Is there bruising at the area?

QUICK TEST

Name the steps for primary survey

What should we look out for when we are surveying casualty’s Breath?

What should we look out for when we look at skin?

STEP 2: ASSESS CASUALTY’S CONDITIONSECONDARY SURVEY

Carry out secondary survey (If treatment is non-critical or if there is a second first aider present) External clues

Medication Warming bracelets Auto injector Inhalers

Getting a full picture of the accident/incident from by-standers/witnesses How incident happen? Any injuries sustained? Medical History? Environment? Time of injuries?

GENERAL SITUATION

5 Simple Steps:




Treatment


Condition


STEP 3: DETERMINE AND PERFORM NECESSARY TREATMENT

This is where the other areas of First Aid comes in: CPR and AED Choking Transportation of Casualty Wound and Bleeding Bites and Stings Environmental Injuries Respiratory Problems Bones, Joints and Muscle Injuries Other Simple Medical Problems

GENERAL SITUATION

5 Simple Steps:




Treatment


Condition


STEP 4: MAINTAIN AND MONITOR CASUALTY’S CONDITION

Regularly Monitor and record vital signs Level of response Pulse Breathing Any deterioration of condition

Arrange for After care Ambulance Family member Allow casualty to go home and advise casualty to

see a doctor

STEP 4: MAINTAIN AND MONITOR CASUALTY’S CONDITION

GENERAL SITUATION

5 Simple Steps:




Treatment


Condition


STEP 5: HANDOVER TO PARAMEDICS

Reporting to Paramedics Advice is to write down the required information( Get

passer by to write)

Information valuable to Paramedics: Casualty’s Name and address History of incident or illness Brief description of any injuries Any unusual behavior Any treatment given, and when Level of response, pulse and breathing.

Questions?

Thank you for your attention

Documents

C ASUALTY A SSESSMENT (P RIMARY AND S ECONDARY S URVEY ) N OTE : NOTES BASED ON NON MASS - CAT SITUATIONS Prepared By: Corps SO(5) Wilson Cheng Wei Sheng