EMP 196

Advanced Patient Assessment – Trauma

1.) Scene Survey

a. Body Substance Isolation

b. Scene Safety

c. Number of Patients

d. Mechanism of Injury (MOI)

e. Need for additional help

2.) Initial Assessment (Find a problem and fix it!!!!!)

a. General Impression of patients condition

b. Assume C-spine control

c. Level of Consciousness using AVPU

d. A- airway, open airway with the modified jaw thrust

B- breathing, look, listen and feel for breathing and provide O2 via BVM/OPA

C- circulation, Check Carotid and Radial pulses, skin color, temp., and condition, and CRT (for peds).

D- disrobe.

E- evaluate major uncontrolled bleeding and apply direct pressure

e. Call “LOAD AND GO” at the diaphragm (or the load and go muscle)

3.) Rapid Assessment

1. Assess the head – look for major deformities, bleeding from the nose and ears, Check pupils.
2. Assess the neck- look for midline trachea, Jugular Vain Distention (JVD), and feel the back of the neck for deformities.
3. Assess the chest- look, listen, and feel the chest, listen to heart tones

d. Assess Abdomen – look and feel

e. Assess Pelvis and Pubic bone- press in and down examine genitals

f. Assess 5 points down Right and Left legs and PMS

g. Assess 5 points down Right and Left arms and PMS

4.) Package

a. C-spine the patient

b. Apply Cervical Collar

c. Log Roll the Patient to the uninjured side

4. Assess the patient’s posterior side including head, neck, back, buttocks, and legs.
5. Log Roll the patient onto the long spine board and secure in place with a Cervical Immobilization Device (CID) and Straps.

5.) You must NOW say “I am now transporting the patient.”

6.) Treatment Phase (to be done in the back of the ambulance)

a. Assess vital signs

b. Treat for shock if needed – O2, cover the patient, Shock position and consider PASG.

c. Secure airway by orotracheal intubation or other technique and confirm placement

d. Establish 2 large bore IV’s at appropriate rate or bolus with 15gtt sets and 14g catheters.

c. Obtain SAMPLE history

7.) Ongoing/Detailed Assessment

1. Palpate the scalp, and facial bones
2. Assess for Blood from nose, eyes, and ears – If present do HALO test
3. Check for raccoon eyes or Battle signs
4. Check Pupils
5. Reassess ABC’s
6. Reassess Neck
7. Reassess Chest
8. Reassess Abdomen
9. Reassess Pelvis
10. Reassess Lower extremities and PMS
11. Assess both upper extremities in 5 points and Check PMS
12. Treat minor injuries and splint all fractures

8.) Repeat Vital Signs and Detailed exam until arrival at hospital

D- Deformities

C- Contusions

A- Abrasions

P- Punctures/Penetrations

P- Paradoxical Motion

B- Burns

L- Lacerations

S- Swelling

T- Tenderness

I- Instability

C- Crepitius