Pediatric Trauma Assessment (Primary and Secondary Survey)

Primary Survey The Primary Survey is performed to rapidly identify and manage life-threatening conditions. Priorities include: - Catastrophic Hemorrhage - Airway (with cervical spine control) - Breathing - Circulation - Disability (Neurological Status) - Exposure / Environment Control Pre-Arrival Preparation - Trauma Team Activation: [Indicate if the trauma team was activated and based on what criteria] - Pre-Arrival Briefing: [Summarize team preparation and role allocations before patient arrival] - Medication & Equipment Preparation: [Confirm weight-based drug doses and equipment readiness] - Protective Measures: [Confirm that personal protective equipment and radiation protection were utilized] On Arrival - Handover: [Document key elements of the I-MIST-AMBO handover from paramedics] - Parental Communication: [Specify any additional history obtained from parents/caregivers] - Support for Family: [Describe any support provided to family members] Airway and Cervical Spine Life Threat: Airway Obstruction - Assessment: [Document airway patency, presence of obstructions such as blood, vomitus, or teeth, facial fractures, epistaxis, or signs of burns such as soot, singed nasal hair] - Neck Examination: [Include an anterior neck assessment for blunt or penetrating trauma, tracheal deviation, or other airway threats] - Airway Management: [Describe interventions used to maintain a patent airway, including positioning, suction, airway adjuncts, or intubation] - Cervical Spine Management: [Confirm spinal precautions and method of stabilization applied] Breathing Life Threats: Tension Pneumothorax, Open Pneumothorax, Massive Hemothorax, Flail Chest - Assessment: [Describe the work of breathing, chest expansion, respiratory effort, and any signs of injury] - Examination: [Include findings from inspection, palpation, auscultation, and any bedside imaging such as chest X-ray] - Management: [Document interventions such as oxygen administration, decompression techniques, or chest drain insertion] Circulation Life Threat: Hemorrhagic Shock - Assessment: [Describe heart rate, capillary refill time, blood pressure, and skin perfusion] - Sites of Bleeding: [Identify external and internal bleeding sources, including thoracic, abdominal, pelvic, and limb injuries] - Interventions: [Detail fluid resuscitation, use of blood products, hemostatic agents, and surgical consultation] Disability (Neurological Status) Life Threat: Traumatic Brain Injury - Neurological Assessment: [Use AVPU or GCS scale to document mental status] - Pupillary Exam: [Assess for pupil size, reactivity, and signs of neurological compromise] - Motor Function: [Describe limb movements and any neurological deficits noted] - Blood Glucose: [Record capillary blood glucose measurement] - Neuroprotection Strategies: [List measures taken to prevent secondary brain injury] Exposure and Environmental Control - Full Body Inspection: [Describe any additional life-threatening injuries identified upon full exposure] - Hypothermia Prevention: [Describe warming techniques and measures used to maintain normothermia] Radiology and Imaging - Imaging Ordered: [List initial imaging studies such as chest X-ray, pelvic X-ray, or CT scans] - Findings: [Summarize significant imaging findings relevant to trauma assessment] Secondary Survey The Secondary Survey is performed once the patient is stable, and all immediate life threats are addressed. Preparation - Communication and Reassurance: [Document patient interactions and parental involvement] - Positioning and Comfort: [Specify any measures taken to improve patient comfort, including pain management] Head and Face - Inspection and Palpation: [Assess for scalp lacerations, skull fractures, facial trauma, Battle’s sign, or periorbital bruising] - Eyes: [Describe any eye trauma, foreign bodies, visual impairment, or pupillary changes] - Ears and Nose: [Check for bleeding, CSF leaks, septal hematomas, or tympanic membrane injuries] - Mouth and Jaw: [Examine for oral trauma, dental injuries, or jaw malocclusion] Neck - Inspection: [Describe any neck bruising, tracheal deviation, or swelling] - Palpation: [Assess for vertebral tenderness or subcutaneous emphysema] Chest - Inspection and Palpation: [Assess for seat belt injuries, paradoxical movement, or tenderness] - Auscultation: [Record breath sounds, heart sounds, and any abnormal findings] Abdomen - Inspection and Palpation: [Look for bruising, distension, or tenderness over liver, spleen, or bladder] - Genitourinary Examination: [Assess for signs of trauma, such as blood at the urethral meatus] Pelvis - Inspection and Palpation: [Assess for pelvic instability or tenderness] Limbs - Inspection and Palpation: [Check for fractures, soft tissue injuries, or neurovascular compromise] - Range of Motion: [Describe any limitations in joint movement] Back - Log Roll Assessment: [Document findings from a log roll examination of the spine and buttocks] - Spinal Palpation: [Assess for tenderness or deformities along the vertebral column] Urinalysis - Test Results: [Document findings from urine dipstick or formal urinalysis] Disposition Planning - Ongoing Management: [Specify additional investigations, procedures, or specialist referrals] - Pain Management: [Document analgesia administered and patient response] - Surgical Consideration: [Indicate if operative intervention is required] - Definitive Care Plan: [Describe the plan for continued care, including inpatient admission, ICU transfer, or discharge home] - Handover Details: [State the team responsible for patient care and any formal handover process] (Never come up with your own patient details, assessment, plan, interventions, evaluation, and plan for continuing care - use only the transcript, contextual notes, or clinical note as a reference for the information included in your note. If any information related to a placeholder has not been explicitly mentioned in the transcript, contextual notes, or clinical note, you must not state the information has not been explicitly mentioned in your output, just leave the relevant placeholder or omit the placeholder completely.) (Use as many lines, paragraphs, or bullet points, depending on the format, as needed to capture all the relevant information from the transcript.)