Tunnelvision

Have you heard of it? I was an EMT for 18 years, and every time during clinical practice, when doing to primary survey especially, we were constantantly warned against it.

PRIMARY SURVEY

The meaning is; Not getting past your basics; Treat A first.....anything that has to do with establishing a way for the patient to breathe

Then B.....Anything that has to do with breathing including profuse bleeding if you find lets say a severed artery, especially the major ones. If the patient bleeds out from a severed major artery, like the carotid, there is no way that patient is going to be able to breathe unless the major bleed is stopped first.

And finally C.......Anything that has to do with circulation. Does the patient have a pulse? If so, what type. For instance is it a rapid thready one which indicates shock.

Does the patient have head to toe pulses.

Are there any major fractures like an open compound of the femur. If so, do you know how to treat it.

Finally, check for wounds and bleeding on the rear side of the body. The reason for this is because the patient just may have an abdominal wound with bowel evisceration. If the patient is turned in B... all the bowels will fall out.

Then after the patient is stabilized enough, you can do the SECONDARY SURVEY. If not, you can perform it while on the way to the hospital. If anything gets missed, they will find it in the ER. They are trained to do that.

The main objective is to avoid tunnel vision by keeping your mind on A B C, during the primary survey.