Primary Survey

Tom RaderStaff - June 8, 2021

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[See the full post at: Primary Survey]

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The text for this lesson is good. Informative and clear.

1. Blood Claw survey. I feel like the first video could use some mention or context around what a “blood claw” survey is. Perhaps it would help to add a description of this in the text. Is this a widely used phrase for this type of survey? I’m not familiar with the instructor’s accent, so it sounded like he was saying “blood qual”. Adding the phrase in text might help to clarify this.
2. Suggestion: What do you think about adding some text after the second video, noting that the instructor performs all of this Primary Survey assessment, and applies the tourniquet *before* calling 911? This seems like an important point to mention – if you are the only responder on the scene, it may be more important to do what you can for any critical CABC injuries first, before calling for help?
3. I like that you are not pulling any punches with this course, and showing up-close footage of realistic looking injuries (e.g. complete with spasms and gushing blood). If I couldn’t handle the sight or thought of a realistic First Aid dummy being injured or bleeding, I should probably work on my mental fortitude before the real situation happens!

 

That Texas accent 😉  Text updated with more description of blood claw. Good idea on the “when to call 911 if alone” context, I’ve added notes.

 

Very informative! Two questions:

1. Do we need to do any sort of assessment regarding potential spinal injuries before moving them around when doing the blood claw check?

2. If we find bleeding while doing the blood claw check, should we stop and address it or keep going? Is it that we should stop and treat if it’s life-threatening but continue if not?

 

1. The short answer is no. You’ll learn in the spine lesson that you don’t have to baby people’s spine the way movies make it seem, especially when there isn’t an obvious sign you should be careful. eg. If someone rolled down a big cliff and you come across them while they’re twisted up like a pretzel, then sure, try to be delicate until you’ve “cleared” the spine. But in most situations, you’re probably not going to cause more harm, and the CABC stuff is more important.

2. The latter. You’re trying to find imminent threats to life. As you blood claw, you may find non-imminent threats, but make mental note and keep moving on. You wouldn’t want someone to bleed out from a leg hemorrhage if you stopped to treat a not-urgent impalement on their shoulder, for example.

You DO stop and take care of what you find if it’s life threatening. Which is part of why the blood claw starts at the head and works its way down.

 

Got it, thank you; that makes sense! I wonder if the spine stuff has historically been so overemphasized for liability reasons rather than medical ones–good to know that it’s not always the most important thing.

 

Answering #2:

We fix it as we find it… as it relates to the type of assessment being performed.

example: if you are “clawing” down a leg and find it bleeding moderately or severely.  Then you would stop there and treat it accordingly.  However if you found a small cut, note it mentally but continue on. 

 

Minor issue with that first video on “blood claw”: That dummy has an obvious, severe leg injury which is completely ignored in a search for more minor injuries. Even doing a claw over that injury and finding nothing…

I get that the technique is intended more for situations without obvious injuries, and this was just the dummy that was already available. Would be good to just take a moment to note why that injury was being ignored (“pretend it’s not there” or “we already stopped bleeding on leg”).

Second video is excellent and more than makes up for that.

 

Thanks, good point. I suspect Caleb thought the blown off leg was obvious 🙂 

 

I appreciate how the “Primary Survey” unit closely corresponds with and covers the use of the recommended supplies for the Prepared’s Level I IFAK–tourniquets, pressure dressings, z-fold gauze, and chest seals.  One Level I item, however, that wasn’t demonstrated is coban wrap.  Is that something that I might use in stopping a life-threatening bleed?  And, if so, how?  Or does that have another purpose?

Thanks for the clarification!

 

Although I wouldn’t be surprised if I met a pro that said they use coban for critical threats, coban is generally used for non-critical things like splinting. Which is why it’s in the IFAK for things like rolled ankles.

But since it’s sticky etc, you could use it to secure a pressure dressing or packed wound, if that’s all you had and someone’s life was on the line. I don’t see why it wouldn’t work.