Exam

Primary Survey Disability Evaluation

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Primary Survey Disability Evaluation, Emergency Disability Management, Emergency Neurologic Exam, Trauma Neurologic Exam

  1. See Rapid ABC Assessment
  2. Glasgow Coma Scale (E-V-M system 3-15 points)
  3. Level of Consciousness: (AVPU system)
    1. Alert
    2. Vocal Stimuli
    3. Painful stimuli
    4. Unresponsive
  4. Pupil response
  1. Repeat Glasgow Coma Scale
    1. Compare to Primary Survey score
    2. Serial evaluations should include at least 2 GCS scores: On ED presentation and on disposition
  2. Sensory Exam
  3. Reflex Exam
  4. Motor Exam
  5. Rectal Sphincter Tone
  • Imaging
  1. See CT Head
  • Differential Diagnosis
  1. Altered Level of Consciousness
    1. See Trauma pitfalls above
    2. See Altered Level of Consciousness
    3. Delirium
    4. Cerebrovascular Accident
  2. Unconscious Trauma patient
    1. Bilateral cerebral cortex injury
    2. Brain Stem injury
  • References
  1. (2012) ATLS Manual, American College of Surgeons