E
Emergency patient: Primary and secondary survey
Recognition of life-threatening illness or injury is one of the most important goals of emergency nursing. Initiation of interventions to reverse or prevent a crisis often is a priority before a diagnosis is made. This process begins with your first contact with the patient. Prompt identification of patients requiring immediate treatment and determination of appropriate interventions are essential nurse competencies.
Initially, assess the patient for any threats to life (e.g., Is the patient dying?) or presence of a high-risk situation (e.g., Is this a patient who should not wait to be seen?). After you complete the initial focused assessment to determine the presence of actual or potential threats to life, proceed with a more detailed assessment. A systematic approach to this assessment decreases the time required to identify potential threats to life and minimizes the risk of overlooking a life-threatening condition. A primary survey and a secondary survey are the approaches to use with all trauma patients.
The primary survey focuses on airway, breathing, circulation (ABC), disability, and exposure/environmental control. It aims to identify life-threatening conditions so that appropriate interventions can be initiated. You may identify life-threatening conditions related to ABCs (Table 94) at any point during the primary survey. When this occurs, start interventions immediately and before moving to the next step of the survey.
Table 94
Potential Life-Threatening Conditions Found During Primary Survey*
