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Fifteen-minute consultation: A guide to the paediatric primary survey
  1. Karl Kavanagh1,
  2. Stephen Mullen2,
  3. Charlotte Sloane2,
  4. Ben Watson2,
  5. Thomas Waterfield2,3,
  6. Nuala Quinn1
  1. 1 Emergency Department, Temple Street Children's University Hospital, Dublin, Dublin, Ireland
  2. 2 Paediatric Emergency Department, Royal Belfast Hospital for Sick Children, Belfast, Belfast, UK
  3. 3 Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, Belfast, UK
  1. Correspondence to Dr Thomas Waterfield, Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast BT9 7BL, UK; thomas.waterfield{at}googlemail.com

Abstract

It’s 21:00 and you receive a stand-by call from the local ambulance service. Peter, a 9-year-old boy, was riding an electric scooter and has collided with a car. He has reduced consciousness, signs of shock and is hypoxic. How will you prepare your team? What are the possible injuries? Who will perform the primary survey? Injury is the leading cause of morbidity and mortality in the paediatric population accounting for approximately half of all attendances to paediatric emergency departments in the UK and Ireland. Major trauma can be distressing for patients, parents and physicians. Managing major trauma is challenging and it is vital to have a clear and organised approach. In this 15-minute guide we describe a structured approach to the primary survey that includes how to prepare before the child’s arrival, the suggested roles of team members and the key components of the primary survey. We discuss life-threatening injuries, the life-saving bundle and the principles of resuscitation, and the role of imaging in the initial assessment of the injured child.

  • Emergency Care
  • Emergency Service, Hospital
  • Paediatric Emergency Medicine

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Footnotes

  • Twitter @drkarlkavanagh, @drs_mullen, @DrNualaQuinn

  • Contributors All authors contributed to the structure and design of this manuscript. KK produced the initial draft. TW, SM and NQ reviewed and edited the manuscript. NQ provided figures 1–3. BW and CS produced figure 4 and all authors reviewed the final submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.