EMS EMT_Ref Patient Assessment

EMS EMT_Ref Patient Assessment - Patient Assessment Scene...

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Patient Assessment Scene Size Up Initial Assessment Rapid or Focused Exam Detailed Exam Ongoing Assessment Scene Size Up BSI: Scene Safety Is the scene Safe? If not, what can be done to make it safe? What safety support services do we need to make it safe? If scene is not safe do not enter! Mechanism of Injury/ Nature of Illness Resources Determine the number of patients, request additional help if appropriate (before starting treatments C-Spine Precautions Appropriate? Initial Assessment Form a general impression of the patient : age, sex, race & severity of the problem / MOI; load & go or stay & play
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Check for responsiveness-level of consciousness (AVPU) Determine chief complaint, Do any apparent life threats exist? (ABC’s) MANAGE LIFE THREATS IMMEDIATELY Form a general impression Age, sex, race & severity of the problem / MOI; load & go or stay & play Check for responsiveness-level of consciousness (AVPU) A&OX3 Do you know your name? Do you know where you are? Do you know what day of the week it is? Do you know about what time of day it is? ABC’s TREAT AS YOU GO!!! A = Airway, is it open? What method is appropriate for establishing the airway? Will it stay open? Do we need an adjunct? Look, Listen & Feel B reathing= Is it adequate? Is it inadequate? Do we need O2? Do we need to ventilate? Auscultation in two places for air exchange. Manage any serious chest trauma, seal any holes and stabilize any flail segments. C irculation= Is there any serious bleeding? If so Manage it. Do we have a radial pulse? If not do we have a carotid pulse? If not start CPR. Take quick look for medic alert tag. Identify the priority of the patient, update responding EMS units Capillary Refill check for infants and children Identify the priority of the patient transport. Understand the CUPS system since ER Physicians still rely on this scale Trauma Center Transport Decision is based on the following:
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Physical Findings for Trauma Deferral Glasgow Coma Scale Less than 13 Respiratory rate <10 or>29 Pulse <50 or >120 Systolic BP< 90 mmHg Penetrating injury to head, neck, torso, or proximal extremities Two or more suspected proximal long bone fractures Suspected flail chest Suspected spinal cord injury or limb paralysis Amputation (except digits) Suspected pelvic fracture Open depressed skull fracture Mechanism of Injury for Trauma Deferral Ejection or Partial ejection from an automobile Death in same passenger compartment Extrication time in excess of 20 minutes Vehicle collision resulting in 12 “ or more of intrusion into the passenger compartment Motorcycle crash >20 MPH or with separation of rider from motorcycle. Falls from greater than 20 feet Vehicle rollover (90 degree rotation or more) with unrestrained passenger Vehicle vs. pedestrian or bicycle Collision >5 DO NOT DELAY TRANSPORT If Appropriate Request ALS intercept Consider Air Medical Transport Focused or Rapid Physical Exam Assessment Keep in mind the “Golden Hour” Select an appropriate assessment mode,
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EMS EMT_Ref Patient Assessment - Patient Assessment Scene...

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