3 - Primary Survey - VIdeo 2 - Initial Assessment Demo

Jul 17, 2026 08:54 · 10:56 · English · Whisper Large V3 · 3 स्पीकर
इस हस्तलिपि का समय ख़त्म हो गया. 3 दिन. स्थायी भंडारण के लिए अद्यतन करें →
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सिर्फ दिखाएँ
0:00
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Old motor vehicle crash victim.
0:02
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Unrestrained driver.
0:03
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Sounds like he's a little unstable in the field.
0:07
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Heart rate is in the 120s.
0:08
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Blood pressure is 90 over 40.
0:10
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
He's got an obvious left femur fracture.
0:13
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
They have him in a hair traction splint.
0:15
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
He's backboarded collared.
0:17
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
They have him on some oxygen.
0:19
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
It sounds like his O2 sats are in the 88 to 93 percent.
0:23
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And his GCS is poor.
0:25
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
So minimal responsive,
0:26
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
and they've got some oxygen going.
0:27
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
They have oxygen.
0:28
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
One IV?
0:29
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
One IV,
0:30
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
I think 18 in the right AC.
0:32
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
All right. So it sounds like this guy is pretty injured.
0:34
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
We're going to need to take care of a lot of things.
0:36
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
It sounds like he's an airway problem.
0:37
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
It sounds like he's in shock.
0:38
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
So there are a couple quick things we need to do very quickly when it gets here is let's make sure
0:42
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
that we've got our airway stuff ready to go.
0:44
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
It sounds like we need to be intubated.
0:45
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
So we've got everything we need.
0:46
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
I've got everything else.
0:47
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
All right.
0:48
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And Betsy,
0:49
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
it sounds like he's only got one IV.
0:51
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
So when he arrives,
0:52
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
what I'd like you to do is put a second IV in on his other side that
0:56
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
he doesn't have one.
0:57
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
We'll get some blood out of that when we do it.
0:59
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Also, if you would call the lab and x -ray before he gets here,
1:02
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
make sure they come and help us out.
1:04
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And Tracy,
1:05
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
when he gets her also,
1:06
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
I'm going to look at his airway.
1:08
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And while I'm doing that,
1:09
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
can you put him on a monitor and a blood pressure cuff?
1:11
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And let me know immediately what the vital signs are so we can go from there.
1:16
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And I guess the other thing we ought to think about is this guy's probably bleeding a fair amount from the sounds
1:20
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
of it. So let's notify the blood bank and let's get the massive transfusion
1:24
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
protocol on standby and make sure that we got that ready to go.
1:27
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Also sounds like this guy is a little too sick for us to keep here.
1:31
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
So once we figure out what's going on,
1:34
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
let's get the trauma center on the phone because I'd like to talk to him and get him transferred.
1:38
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Okay? Yes,
1:39
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
sir. Any questions?
1:40
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Let's do it.
1:44
S… Speaker 3 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
This is Gary.
1:45
S… Speaker 3 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
He's 18 years old.
1:46
S… Speaker 3 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
He's an unrestrained driver in a single vehicle MBA into a tree.
1:50
S… Speaker 3 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
About 10 minute extrication.
1:52
S… Speaker 3 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
He's a GCS of about 8.
1:53
S… Speaker 3 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Has a head injury up here underneath the gauze and has an open femur fracture with some minor bleeding.
1:58
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Motor vehicle collision into a tree.
2:00
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Prolonged extrication.
2:02
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
He's unrestrained.
2:03
S… Speaker 3 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Unrestrained.
2:04
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And you said he's got an obvious head injury?
2:06
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Obvious head injury.
2:07
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And an obvious femur fracture?
2:09
S… Speaker 3 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Open femur fracture.
2:10
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Okay.
2:10
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And that's all you see right now?
2:11
S… Speaker 3 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
The bruising to the left chest as well.
2:13
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And his last set of vitals?
2:15
S… Speaker 3 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Blood pressure is 90 by Pau.
2:16
S… Speaker 3 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
He has 120 sinus attack on the monitor.
2:19
S… Speaker 3 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Respiratory rate was about 12.
2:21
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
It was clear bilaterally.
2:22
S… Speaker 3 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And he's been in response with for us.
2:24
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Any other issues?
2:25
S… Speaker 3 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Nothing I know of.
2:26
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
All right. Thank you very much.
2:27
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Thank you.
2:29
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
All right, guys,
2:30
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
this guy looks like he's got a lot of injuries,
2:31
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
and let's do this in a nice systematic fashion.
2:34
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
We're going to start with the ABCs.
2:35
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
So Tracy,
2:36
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
while I'm assessing the airway,
2:37
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
I want you to put some leads on.
2:40
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Let's get a blood pressure.
2:41
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And Betsy,
2:43
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
if you can come over here on this side and help me with the airway.
2:45
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Looks like he's breathing about 20 times a minute.
2:48
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Sir, can you open your eyes?
2:49
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Sir, what's your name?
2:50
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Looks like he's not responsive at the moment.
2:53
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
He's got some obvious facial trauma.
2:56
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And it looks like he's not breathing real well.
2:58
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
He's a little bit blue.
2:59
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
O2SAT's 82%.
3:00
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
O2SAT's 82%.
3:02
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
So we're going to need to intubate him.
3:03
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
So what I would like you to do,
3:05
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Betsy,
3:06
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
is I want you to hold C -spine precautions here.
3:09
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
I'm going to take the C -spine collar off.
3:10
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And I'm going to put it in an oral airway in here.
3:14
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
See if we can get a little bit better.
3:15
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
All right,
3:16
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
let's put this oral airway in.
3:17
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Let's go ahead and bag him here.
3:19
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Responsive.
3:21
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
It looks like he's going to need to be intubated.
3:23
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Do we have our intubation stuff ready?
3:24
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Everything's right behind you,
3:26
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
ready to go.
3:27
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
All right, can you bag him here while I grab that?
3:29
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
I got it.
3:29
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Can you come off for a second?
3:31
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Let me just take a look here.
3:32
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Looks like we've got a little bit of blood in there.
3:34
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Let me suck that out.
3:35
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
All right.
3:36
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Suction.
3:37
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
All right,
3:38
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
good. Great.
3:40
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
All right,
3:42
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
let me just take a peek here.
3:45
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Let me know if you want some cricoid back for you.
3:47
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Yeah, a little cricoid pressure would be great.
3:48
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Thank you.
3:49
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
All right.
3:51
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
See his cords.
3:52
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Tube's going in.
3:53
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Great.
3:54
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Good
3:59
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
color change.
4:00
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Good color change.
4:01
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
All right.
4:02
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Let's get him hooked up to a ventilator.
4:04
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
In the meantime,
4:05
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
let's put the C -spine collar back on and protect the C -spine.
4:08
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
All right.
4:11
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And let me take a listen to his lungs.
4:14
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Betsy, there's a little bit of bleeding there.
4:15
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Put some pressure on that if you would.
4:17
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Can we call for respiratory and a ventilator,
4:19
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
please? Got it.
4:20
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
I've got good breath sounds on both sides.
4:22
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
A little bit less on the left and the right.
4:24
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
He's got some bruising on his left chest.
4:26
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
So let's see what we've got.
4:27
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
His airway is taking care.
4:28
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
We've got him as intubated.
4:29
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
His pulse ox has come up to 96%.
4:32
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
What are our vital signs doing?
4:34
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Looks like his heart rate's 100.
4:37
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And 15,
4:38
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
and his blood pressure is 90 over 42.
4:39
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
All right, so it looks like he's a little bit in shock.
4:41
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
We've got airway and breathing taken care of.
4:44
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Is he bleeding interactively?
4:45
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
So he's bleeding down here on the leg.
4:48
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Can we get some more help?
4:50
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Hey, Will, can you help us?
4:51
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Yes, go ahead.
4:52
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Dr.
4:52
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Boyer, would you like a second IV?
4:54
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Yes, let's start a second large -bore IV,
4:56
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
and let's hang normal saline.
4:57
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And how much IV is going fluid?
5:00
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Put some pressure on that,
5:00
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
if you would, please.
5:01
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
You keep bagging.
5:02
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Start a second IV over here,
5:04
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Tracy, if you would.
5:05
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And I think this guy's going to need some blood,
5:07
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
so let's call the blood bank and get a massive transfusion protocol going.
5:12
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Okay.
5:12
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
All right.
5:13
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
So we've got control of the bleeding there.
5:15
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Control of the bleeding there.
5:15
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Let me feel his pulses down here.
5:17
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
I think his traction splint seems to be working on me.
5:21
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
He's got good pulses here with some bleeding there.
5:23
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
It looks like an open femur fracture.
5:24
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
I don't see any obvious bleeding on his chest.
5:28
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
His abdomen is soft.
5:30
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
His pelvis is not stable.
5:32
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
I think he's got a pelvic fracture.
5:33
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
So you could have significant bleeding from there.
5:35
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
So definitely this guy's going to need some blood.
5:37
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
So let's make sure we get some blood products for him.
5:40
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
In the meantime,
5:41
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
let's expose the patient.
5:42
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Does that bleeding seem to be taken care of there as you wrap that,
5:45
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Will? Yep, looks pretty good now.
5:46
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
All right.
5:47
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Can you go ahead and get him exposed?
5:49
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Take off the rest of his clothes there.
5:51
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And once we get him exposed,
5:53
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
let's make sure we get some warm blankets to cover him back up so we don't get hypothermic.
5:57
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Let's do a disability exam.
5:59
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
All right, sir,
6:00
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
can you open your eyes?
6:01
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
He opens his eyes to pain.
6:04
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
That's a two.
6:05
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
He wasn't verbalizing,
6:07
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
so that was a one.
6:08
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Let me see if he responds to painful stimuli.
6:10
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
He's localizing,
6:11
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
so that's a four.
6:12
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
That looks like he's got a significant head injury,
6:15
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
and we're going to need to get him to a neurosurgeon.
6:17
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
In the meantime,
6:18
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
let's keep oxygenating him.
6:19
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
What's his blood pressure doing now?
6:21
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Looks like,
6:22
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
let's see, it's up to 105 systolic.
6:26
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Partly it's down to 100.
6:28
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
We also,
6:29
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
I think we're going to need to wrap this pelvis with a sheet.
6:32
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Can you grab a sheet for me there,
6:33
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Will? Let's go ahead and make sure we wrap this pelvis.
6:37
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And we're going to need to log roll him.
6:39
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
So we've got him hooked to a ventilator.
6:41
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Coming up.
6:42
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
All
6:47
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
right. This is going to be on your count.
6:48
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
You count it down for us on the count of three.
6:50
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
If you're one,
6:51
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
two,
6:52
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
and three.
6:53
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
All right.
6:55
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Let me get this backboard out.
6:56
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And
7:00
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
I'm going to examine his spine here to make sure there's no step -off.
7:04
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Feels like there's no step off here.
7:06
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Let's do a rectal exam.
7:07
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
I need some jelly for that.
7:09
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
All right.
7:10
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
All right.
7:12
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
He's got good rectal tone.
7:14
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And while I've got him up here on the side,
7:18
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
let's put the x -ray plates in to get a chest and a pelvic x -ray.
7:20
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Watch the IV,
7:22
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
sir.
7:22
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
All right.
7:23
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And let's bring him back on your count again.
7:26
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Ready?
7:27
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
One, two,
7:28
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
and three.
7:29
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Can we call for x -ray,
7:31
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
please?
7:32
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
All right.
7:37
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
We'd like a chest and a pelvis.
7:39
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Yes,
7:40
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
sir.
7:40
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
All right, guys,
7:41
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
let's reassess what we've done so far.
7:43
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
We've done our ABCs.
7:45
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
We've got his airway control.
7:46
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
We've assessed his breathing.
7:48
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
He's got good breath sounds,
7:49
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
a little bit of diminishment on the left -hand side.
7:51
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
We know that he has a pelvic fracture and some bleeding from an open femur fracture.
7:55
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
We've reduced that.
7:56
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
We've got good pulses.
7:57
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
He's also got some bleeding from his scalp and an obvious head injury.
8:00
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
So this guy,
8:01
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
clearly, we need to transfer him to a trauma center.
8:03
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
So what I'd like to do at this juncture is we'll take a look at those x -rays we shot.
8:08
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
I want you to put an OG tube in because of concern for a head injury,
8:11
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
and I want you to put a Foley catheter in in a moment here.
8:14
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And then what we'll do is reassess the patient.
8:16
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
What are his vital signs right now?
8:17
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Currently,
8:18
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
his O2 set is 96%.
8:20
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
His blood pressure is 110 over 64.
8:22
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Heart rate is 97.
8:23
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And we've given him how much fluids?
8:25
S… Speaker 2 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
500 cc of saline and 2 units of Paxil.
8:28
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
2 units of Paxil and 500 cc saline.
8:30
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
So it sounds like we've stabilized him a little bit.
8:32
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
We've got a sheet around his pelvis here.
8:36
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
We're going to get him packaged up for the trauma center.
8:39
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
So, Betsy,
8:40
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
could you get the trauma center on the phone for me?
8:42
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
I need to talk to them and arrange transport.
8:44
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And while we're doing that,
8:46
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
we're going to do a detailed secondary survey.
8:48
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
We're going to do a head -to -toe,
8:49
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
fingers and tubes in every orifice exam.
8:51
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
We'll get him all packaged up to go.
8:53
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And also,
8:54
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Betsy, could you make sure that the x -ray department makes copies of all of our x
8:58
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
-rays so we can send them along?
9:00
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Tracy, it looks like we've got our x -rays back.
9:02
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
We've got a chest here.
9:03
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
It looks like he's got some rib fractures here on the left side and some
9:08
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
haziness.
9:08
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
He's probably got a pulmonary contusion.
9:09
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And his pelvic film,
9:11
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
he's got an acetabular fracture,
9:14
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
a pelvic fracture.
9:15
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
That confirms,
9:17
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
I think, what we think is going on with his blood loss.
9:19
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Let's get copies of these x -rays made and send them so we can send them on
9:23
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
to the next hospital with him,
9:25
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
okay?
9:27
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Dr.
9:28
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Brezel, hi.
9:28
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
This is Mark Boyer from Mary,
9:30
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Washington.
9:30
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
I've got a patient that I need to transfer to you.
9:33
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
It's an 18 -year -old young male who
9:37
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
was involved in a high -speed motor vehicle collision.
9:39
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
He ran his car off the road into a tree.
9:41
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
There was significant damage to the front end of the car.
9:45
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
He was unrestrained.
9:46
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Apparently,
9:47
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
he was unresponsive at the scene.
9:48
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
We intubated him.
9:57
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Some rib fractures,
9:58
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
and he's also got what appears to be a pulmonary
10:02
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
contusion.
10:03
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
He's also got bleeding from a scalp wound.
10:06
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
He's got an open femur fracture on the left side.
10:08
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
We've immobilized it.
10:09
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
He's also got a pelvic fracture.
10:11
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
We've got him in a pelvic sling right now.
10:12
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
We've given him two liters of fluid.
10:15
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
He's got two units of blood.
10:16
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
His blood pressure right now is 110 over 50.
10:20
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
His heart rate is 110.
10:22
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And we've got him intubated on 100 % oxygen with 98 % saturation.
10:27
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Yeah,
10:29
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
I think that he probably needs to come by air.
10:33
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
So if we can make the arrangements to send the helicopter,
10:36
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
I'd appreciate it.
10:37
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And I will package him up.
10:39
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
I'll send some blood products and we'll send the x -rays as well.
10:41
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
And we'll await your arrival.
10:44
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
In the meantime, I'll get some x -rays of his femur and everything
10:49
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
else, but we won't delay his transport.
10:50
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
Any other questions?
10:54
S… Speaker 1 (3 - Primary Survey - VIdeo 2 - Initial Assessment Demo)
No, thanks. Thank you very much.

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