Lesson 1Exposure and environmental control: complete undressing, warmers, preventing hypothermia, and rapid secondary survey prepThis section covers full patient exposure for injury detection while preventing hypothermia. It addresses safe undressing, privacy, warming strategies, environmental control, and efficient preparation for a rapid yet systematic secondary survey in resource-limited Ghanaian facilities.
Safe clothing removal and patient dignitySystematic head to toe visual inspectionUse of warm blankets and active warmersRoom temperature and warmed IV fluidsCoordination for rapid secondary surveyLesson 2Breathing assessment: inspection, auscultation, percussion, oxygenation targets, and bedside monitoringThis section reviews rapid breathing assessment, including inspection, auscultation, percussion, and bedside monitoring. It emphasises oxygenation targets, recognition of life-threatening chest injuries, and prioritisation of immediate corrective actions in Ghanaian trauma care.
Inspection for chest rise and deformityAuscultation for breath sound asymmetryPercussion for hyperresonance or dullnessPulse oximetry and waveform evaluationOxygenation and ventilation targetsLesson 3Airway maneuvers and adjuncts: jaw-thrust, oral/nasopharyngeal airways, RSI steps and drug choicesThis section reviews airway manoeuvres and adjuncts used during the primary survey. It includes jaw thrust, oropharyngeal and nasopharyngeal airways, indications and steps for RSI, and selection of induction and paralytic drugs in trauma, adapted for Ghanaian resources.
Jaw thrust and manual airway openingUse of oropharyngeal airwaysUse of nasopharyngeal airwaysPreoxygenation and RSI preparationDrug choices and dosing in RSILesson 4Airway assessment: signs of obstruction, indications for immediate airway control, and rapid intubation criteriaThis section focuses on rapid airway assessment in trauma. It highlights signs of obstruction, predictors of difficult airway, indications for immediate control, and criteria for rapid intubation versus temporary adjuncts or surgical airway in Ghanaian settings.
Visible obstruction and noisy breathingAssessment of airway burns and edemaPredictors of difficult laryngoscopyIndications for immediate intubationWhen to consider surgical airwayLesson 5C-spine protection: manual inline stabilization, collar types, and indications for immobilization vs. clearanceThis section addresses cervical spine protection during initial trauma care. It covers manual inline stabilisation, collar selection and fitting, indications for immobilisation, and criteria for safe clearance using clinical and imaging pathways available in Ghana.
Manual inline stabilization techniquesChoosing and sizing cervical collarsProper collar application and pitfallsClinical criteria for C-spine clearanceImaging indications for C-spine injuryLesson 6Resuscitation endpoints and monitoring during primary survey: blood pressure targets, heart rate, urine output, and mental statusThis section explains resuscitation endpoints and monitoring during the primary survey. It covers blood pressure and heart rate targets, urine output, mental status, lactate trends, and how to adjust interventions based on dynamic patient response in Ghanaian hospitals.
Target blood pressure in trauma shockHeart rate and rhythm trend analysisUrine output as perfusion indicatorMental status and serial GCS checksUse of lactate and base deficitLesson 7Disability brief neuro assessment (GCS) and immediate neurologic stabilization measuresThis section outlines the brief neurologic assessment in the primary survey. It explains rapid GCS scoring, pupillary checks, limb movement, and immediate stabilisation steps for suspected brain or spinal injury, including airway and perfusion optimisation.
Rapid GCS components and scoringPupil size, symmetry, and reactivityMotor and sensory limb assessmentSigns of raised intracranial pressureImmediate neuroprotective measuresLesson 8Circulation assessment: hemorrhage control priorities, signs of shock, focused physical exam for major bleedingThis section explains circulation assessment during the primary survey, focusing on rapid detection of life-threatening haemorrhage, recognition of shock, targeted physical examination, and prioritisation of immediate bleeding control measures in Ghana.
Central and peripheral pulse assessmentSkin colour, temperature, and capillary refillBlood pressure trends and shock index useFocused exam for external and internal bleedingEarly IV or IO access and blood samplingLesson 9Immediate interventions for breathing threats: needle decompression, tube thoracostomy, and strategies for tension pneumothoraxThis section details immediate interventions for life-threatening breathing problems. It covers needle decompression, tube thoracostomy, recognition of tension pneumothorax, and strategies to prioritise procedures within the time-critical primary survey in Ghanaian care.
Recognition of tension pneumothoraxSites and technique for needle decompressionIndications for tube thoracostomyChest tube insertion steps and checksPost procedure monitoring and reassessmentLesson 10Immediate hemorrhage control: direct pressure, tourniquets, pelvic binders, hemostatic dressings, and FAST-guided decisionsThis section focuses on immediate haemorrhage control techniques used in the primary survey. It details direct pressure, tourniquets, pelvic binders, haemostatic dressings, and how FAST findings guide urgent operative or interventional decisions in Ghana.
Effective application of direct pressureIndications and placement of tourniquetsPelvic binder sizing and positioningSelection and use of hemostatic dressingsIntegrating FAST results into decisionsLesson 11Structured primary survey (ABCDE) sequence and time goalsThis section describes the structured ABCDE primary survey sequence and time goals. It emphasises prioritising life threats, minimising interruptions, team role allocation, and continuous reassessment to maintain a safe, efficient trauma workflow in Ghana.
Overview of ABCDE survey prioritiesRecommended time targets for ABCDETeam roles and closed loop communicationManaging simultaneous interventionsReassessment after each ABCDE cycle
