Patient and Assessment

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Patient and Assessment

• By Ethan, Steve and Dave

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Airway with C-Spine Control

• takes or directs manual inline immobilization of
  the head
• This is done to prevent any injury to the neck
• opens and assesses airway
• This is done to make sure airway is clear of any
  foreign abject.
• Inserts adjunct
• On a unconscious patient,
  you need to keep the tongue
  of the back of the throat.

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Breathing

• Assesses breathing
• When you assess breathing you need to listen to
  the lungs to find out if air is moving. When you
  do that you should also listen to the sound of
  the lungs.(i.e.. Gurgles, rails,rasps or any air
  exchange at all) Also find the rate to determine
  if you need to bag him.
• Initiates appropriate oxygen therapy
• This is where you put oxygen on the patient and
  determine at what rate.
• Assures adequate ventilation of the patient.
• Manages any injury that may compromise the
  breathing.

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Circulation

• Checks pulse
• There are three major pulse sites.
  Visual location
• Carotid which is in the neck
• Femoral which is in the groin region
• Radial which is in the radius of the arm
• Assesses the peripheral perfusion
• Assess the skin color , temp. of the skin and the
  condition of the skin.
• Controls any major bleeding
• If you find any major bleeding stop what you are
  doing and control it. It might not be a problem
  now, but if untreated it will be a problem.

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Circulation

• Takes Vital signs
• Blood pressure, pulse and respiration's are the
  three vitals.
• Volume replacement
• this is where you determine if you need a IV line
  in the patient.
• If pt. Has lost amount of blood pt needs a line.
• If pt is a cardiac pt , he needs a line.
• When in doubt, ask Medical Control
• Large bore IVs are for large amount of fluids
  going in. Like a trauma victim.
• Small bore are for possible pts that will need
  medications at the hospital

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Performs Neuro Exam

• Determine if the patient has any neurological
  problems.
• Use the AVPU scale
• A- Alert., is the patient alert and talking to
  you and aware of his surroundings
• P-Pain, does the patient respond to pain
• V-verbal, does the patient respond to your verbal
  commands.
• U-unresponsive, is the patient unresponsive .

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Expose

• This is where you look for DCAP BTLS
• D- deformities
• C-contusions
• A-abrasions
• P-punctures and perforations
• B-bruising
• T-tenderness
• L-lacerations
• S-swelling

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Status

• This is where you make the call, stay and play or
  load on go. This is all the marbles, you need to
  use your skills and your partners to make the
  right decision.

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SECONDARY SURVEY

• If you stay and play there will be time to assess
  patient further.

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HEAD

• You should check the mouth, nose, facial area for
  any DCAP BTLS signs.
• The scalp and ears should be palpated also for
  DCAP BTLS signs.
• You should also check the pupils to see if they
  are equal, round and reactive to light.

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NECK

• Be sure and check the position of the trachea.
  Making sure there is NO tracheal deviation.
• Check jugular veins for distension.
• View and palpate Cervical Spine (C-Spine) for any
  signs of DCAP BTLS

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CHEST/THORAX

• View chest/thorax area. Check for any signs of
  DCAP-BTLS.
• Palpate Chest/Thorax area. Check for any signs
  of flail chest.
• Auscultate chest/thorax area. Make sure lung
  sounds are clear and equal bilaterally.

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ABDOMEN/PELVIS

• View and palpate abdomen for any signs of
  DCAP-BTLS.
• Assess pelvis for and signs of DCAP-BTLS. Check
  for crepites.

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LOWER EXTREMITIES

• View and palpate the LEFT leg for any signs of
  DCAP-BTLS.
• View and Palpate the RIGHT leg for any signs of
  DCAP-BTLS.
• Check Distal Circulation, Motor, Sensory (CMS).

Lower extremities
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UPPER EXTREMITIES

• View and palpate the LEFT arm for any signs of
  DCAP-BTLS.
• View and Palpate the RIGHT arm for any signs of
  DCAP-BTLS.
• Check Distal Circulation, Motor, Sensory (CMS)

upper extremities
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POSTERIOR THORAX/LUMBARBUTTOCKS

• View and palpate posterior thorax for any signs
  of DCAP-BTLS.
• View and palpate lumbar and buttocks area for any
  signs of DCAP-BTLS.
• Identify and treat minor wounds/fractures
  appropriately.

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Critical Criteria

• Failure to initiate or call for transport of the
  patient within 10 minutes.
• Failure to take or verbalize Body Substance
  Isolation Precautions.
• Failure to initiate or maintain spinal
  stabilization.
• Failure to provide high concentration O2.
• Failure to find and evaluate all conditions
  related to the ABCs.
• Failure to appropriately manage the ABCs.
• Failure to assess transportation priority.
• Failure to treat threats to the ABCs before
  doing the Secondary Survey.

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The END.

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