Primary Survey, Secondary Survey

The management of trauma has been altered by the introduction of what is now a routine approach, labeled differently in different continents as a trauma management system. In the United States it is called ATLS (Advanced Trauma Life support).  It is a step wise approach that emphasizes the most important things first the next important next, and comes back to the most important things again, a cycle that propels the victim towards a thorough and safe recovery.  These processes are called Primary survey, and Secondary survey. Primary survey includes the following steps:

·      Airway and cervical spine

·      Breathing

·      Circulation

Secondary survey is a head to toe evaluation of the whole person, looking for injuries systematically and dealing with them.

In Christian life, we are often confronted by very confusing and traumatic circumstances in different arenas of our lives. It may be at home, at the workplace, or with our friends. Our responses vary and are patchy, leaving gaping holes and often times regret that we might have reacted differently given a second chance to do so. Quite often the second chance never comes our way again.

An  ATLS approach to these circumstances may give us a chance to react consistently and correctly every time. The reason we “drop the ball” is that we often have not positioned ourselves in a correct vantage point, which colours the nature and character of our reaction.

Substituting some basics into the mnemonic for Primary survey that applies to every one, all the time, every time, it will benefit us enormously if we realize that:

·      A All have sinned. (Rom 3:23). We forget that we are all sinners, and our position is not one of pedestalled sanctity, but as a sinner ourselves, with no other hope of redemption, just like every one we are dealing with. We are in no position to judge, accuse, or condemn.

·      B Blood. Our only hope of redemption and salvation is the blood of Jesus that was shed for us. It was offered to us not because we deserved it or earned it but because He just allowed us to access it by His undeserved favour. (2 Tim 1:9)

·      C Change. The consequence of A and B is that our perspective is forever changed. We cannot look on the world, our family, or our friends ever again in the same way, but have to regard them through the drizzle of blood that saved our lives, rendering a perspective that has to lead us to think of saving theirs. Every action of ours has to have this perspective and focus. Anger, hurt, disappointment and rancour may undoubtedly be justified emotions, but they are always eclipsed by this view, rendering them no less real, but dwarfed by the possibility of grace that can filter through those very emotions to lead us all to remain at the foot of the cross. Our reactions, consequently, will have to be different, despite our emotions.

In trauma, the surgeon has to occupy a position at the head end of the patient. That is the station from where all evaluation is done. In life, we have to remain at the foot of the cross. Any other position or perspective will always yield a warped view of the world, espousing a reality that excludes our own deprivation and degradation, magnifying the warts on those we are dealing with, changing the reality away from the view of the world from our vantage point A.

Secondary survey then allows us to tackle each situation and instance thoroughly, dealing with sin, and having the grace to allow healing, rather than amputating relationships and causing irremediable hurt in the other person.

This will mean that our own capacity to absorb hurt and negative emotions has to progressively increase, a change that has to happen actively only by the ongoing grace of God allowed to work in our lives.