Primary survey

An all India primary survey on the lamp users indicates that average replacement rate per household per year for CFLs and FTLs is about 1.26 and 1.05, respectively. The survey also indicated that majority of consumers are not willing to take the direct responsibility in funding system, therefore, a decentralized system of collection should work in Indian conditions. The recovery chain has to be clearly established with incentive-based roles identified for household consumers, retailers, and junk dealers. Further, the onward linkages must be assured so that the collected wastes are recycled and residues adequately disposed of. 

The primary survey also revealed information on rate of replacement (number of CFLs and FTLs replaced in 1 year) shows that mean number of CFLs replaced in the past 1 year is 1.26, varies from less than one CFL in Bangalore to two CFLs in Ahmedabad. The corresponding figure for FTL is 1.05 which varies from less than one in Bangalore to two FTLs in Ahmedabad. 

Based on the results of the primary survey and consultations at various levels, one of the findings of this study has been that in order to operationalize a C R mechanism for spent FLs, there is a need for an entity that would take the direct physical responsibility for such a system. 

When the primary survey is complete, a thorough head-to-toe evaluation is conducted to assess for other injuries. This may be done at the scene if time and resources permit or at the first receiving hospital. The secondary survey should include getting an accurate history—the circumstances of the injury and medical history—conducting a complete examination to evaluate for other traumas such as fractures, pneumothoraces, contusions, shrapnel, corneal injury and closely reexamining the burn wound size and depth. 

ATLS and ATCN follow the same primary and secondary surveys. During the primary survey, identification and management of life-threatening injuries occur simultaneously. See Table 13.3 for a description of the primary survey per ATLS protocol. Within the secondary survey, a complete history of the event and past medical history is obtained. To aid and expedite this process, an AMPLE history can be completed. This includes Allergies, Medications, Past illnesses and Pregnancy, Last meal, and Events leading to the injury. A physical examination follows this is more detailed than the initial exam in the primary survey. Table 13.4 outlines assessment considerations during the secondary survey... 

Describe the ABCs of ACLS, ABES, ATLS, and ATCN. How do they differ Which should be followed in the case of an explosion What are the components of the primary survey What are the components of the secondary survey ... 

All information comes from primary survey data collected in 2000. 

Currently, the model most often used for the prediction of biodegradation half-lives is the BIOWIN Primary Survey Model (PSM) from the EPISuite package [39]. This model is described in detail in the chapter by Howard. It is based on the results of an expert survey and uses a group contribution approach to predict biodegradability on a scale from 1 to 5. To convert this output into com-... 

Performing primary survey(s) of victim(s), including airway, breathing and circulation. 

Table 3.1. The primary survey of the trauma patient. From [37], with permission...

Once an adequate airway and breathing of the trauma patient is achieved, the primary survey of the trauma patient addresses the circulatory system. A number of perfusion endpoints must be analyzed to determine whether the patient is adequately resuscitated or dedining into circulatory shock. The predominate cause of shock in the trauma patient is under-perfusion secondary to bleeding. The treatment of shock is to replace the volume lost. By and large, the treatment of shock in the trauma patient has remained unchanged for the past few decades. 

Ahnogy et al describe analysis of their trauma registry to identify independent predictors of BLI penetrating injury to the head and injury to four or more body areas were both predictive. Both of these are easily assessed for in seconds in the primary survey and so provide a rapid sieve for the triaging clinician. 

As a result, the only effective approach is to follow the standard ABCDE protocols combining an initial primary survey for immediately life-threatening injury with a secondary survey designed to ensure that no injury, however trivial, is missed. Radiographs should be taken as appropriate to identify retained missiles or fragments, and to exclude significant occult injury wounds should be marked with radio-opaque markers. 

Table 5.3 Chemical primary survey (adapted from Bland, 2003)...

A system of chemical incident primary survey is illustrated in Table 5.3. The table highlights some of the significant signs and symptoms that may be noted during the primary survey and their association with various potential agents. 

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