Initial Assessment

and Resuscitation

PRIMARY SURVEY
(ABCDE)

Airway
-Manual airway opening maneuvers (Head tiltchin lift, jaw thrust)
- Cervical spine control
Look: cyanosis, altered respiratory pattern &
rate, use of accessory muscles, tracheal tug,
altered level of consciousness, protective
airway reflect (cough, gag)
Feel: noisy breathing (stridor, wheezing,
gurgling)
complete obstruction results in silence
Listen: decreased or absent air flow

Definitive Airway
Endotracheal intubation
Surgical Airway :
Cricothyroidotomy
Tracheostomy

Breathing &
Ventilation
Look: cyanosis, tachypnea, neck vein
distension
Listen: stridor, absent breath sounds,
heart sounds
Feel:
subcutaneous
emphysema,
crepitus, tracheal deviation

Circulation
LOOK : reduced peripheral perfusion (palor,
),
hemorrhage (obvious concealed), altered level of
conciousness, dyspnea, urine output .
Feel : additional or altered heart sounds, carotid
bruits
Listen : precordial cardiac pulsasion, pulses (central
&peripheral) assessing rate, quality, regularity,
symetry
*Assessment: Consciousness, pulses rate, cardiac
pulsasion, quality & regularity, skin temperature, &
blood pressure

Disability (Neurologic
Evaluation)
Consciousness
Pupil size
Light reflex

Exposure
Completely undressed
Prevent hypothermia

RESUSCITATION
Protect and secure airway
Jaw thrust atau chin lift, oropharyngeal
airway,
airway definitive
Oxygenation and ventilation
Stop bleeding
Protect from hypothermia

Adjuncts to Primary Survey

Monitor Vital signs
Arterial blood gas
Pulse oximeter
Urinary/gastric catheters
Urinary output
Monitor EKG
Rontgent

SECONDARY
SURVEY

Secondary Survey
Mechanism of injury
Head-to-toe evaluation
Complete neurologic examination
Image examination
Reevaluation

Anamnesis
Riwayat AMPLE :
A Alergi
M Medikasi
P Past illness (penyakit penyerta/
pregnancy)
L Last meal
E Event/ lingkungan yang berhubungan
dengan kejadian.

Head-to-toe evaluation
1. Head

visus, pupil, raccoon eyes, battle sign, torrhea,

rhinorrhea, scalp injury
2. Neck
Tracheal compression or deviation ,
Hematoma,
emphysema, Spinal injury C-spine, cervical cord, Major
organ injury (Trachea, carotid artery, esophagus)
3. Chest
. chest wall deformity - Rib/sternum fracture, flail
chest
.Ventilation mechanism - Pneumothorax, hemothorax,
cardiac tamponade

5. Abdomen
Hemorrhage - Liver, spleen
Peritonitis - Hollow organ perforation
,Intra abdominal abscess
6. Perineum
7. Musculosceletal
Laseration, deformity, open wound,
fracture

Re-evaluation
Evaluasi penurunan kesadaran
Evaluasi tanda vital dan produksi urin
Penanganan rasa nyeri dan cemas