Patient Assessment And Management

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By Ethan Bjorklund Dave FureyGrant Riedemann

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 airway adjunct– This is done to keep an

unconscious patient’s tongue from closing off the airway.

Breathing

• Assesses breathing• Initiates appropriate oxygen therapy• Assures adequate ventilation of the patient.• Manages any injury that may compromise the

breathing.

Circulation

• Checks pulse• Assesses peripheral perfusion

– Assess either skin color, temperature, or capillary refill.

• Assesses and controls any major bleeding• Takes Vital signs

– Blood pressure, pulse and respiration's are the three vitals.

Circulation (continued)

• Volume replacement•

Click here for an IV Insertion Presentation– This is where you determine if an IV

is needed• Initiates first IV line• Initiates second IV line• Selects appropriate catheters• Selects appropriate IV solutions

and administration sets• Infuses at appropriate rate

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 .

• Applies cervical collar.

Expose

• Removes clothing to expose any unseen injuries.

• This is where you look for DCAP BTLS– D- deformities– C-contusions– A-abrasions– P-punctures and

perforations

Expose (continued)

– B-bruising– T-tenderness– L-lacerations– S-swelling

Status• This is were you get to make the call as the emergency health care provider of whether or not

to immediately transport the patient……..

OR

SECONDARY SURVEY

• This is done if you decide to stay on scene or, if time permits, while enroute to the hospital with a critical patient.

HEAD

• Check the mouth, nose, facial area for any DCAP BTLS signs.

• Inspect and palpate the scalp and ears for DCAP BTLS signs.

• Check the pupils to see if they are equal, round and reactive to light.

NECK

• Check for tracheal deviation.• Check for jugular veins distension.• Palpate the cervical spine.

CHEST

• View chest for any signs of DCAP-BTLS.• Palpate the chest for any trauma. • Auscultate chest for lung sounds.

– Lung sounds should be clear and equal bilaterally.

ABDOMEN/PELVIS

• Inspect and palpate abdomen for any signs of DCAP-BTLS.

• Assess pelvis for and signs of DCAP-BTLS.

LOWER EXTREMITIES

• Inspect and palpate the LEFT and RIGHT leg for any signs of DCAP-BTLS.

• Check each leg for Distal Circulation, Motor,and Sensory (CMS) function.

• Identify and treat minor wounds/fractures appropriately

UPPER EXTREMITIES

• Inspect and palpate the LEFT and RIGHT arm for any signs of DCAP-BTLS.

• Check each leg for Distal Circulation, Motor,and Sensory (CMS) function.

• Identify and treat minor wounds/fractures appropriately

POSTERIOR THORAX/LUMBAR

BUTTOCKS• Inspect and palpate posterior thorax, lumber,

and buttocks areas for any signs of DCAP-BTLS.• Identify and treat minor wounds/fractures

appropriately.

Critical Criteria

• These are actions that will result in automatic failure of station!

• Click here for a link to the National Registry Checklist (This is a PDF file, your computer must have Adobe Acrobat to read it).– 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.

Critical Criteria (continued)

– Failure to provide high concentration oxygen.

– Failure to find and evaluate all conditions related to the ABC’s.

– Failure to appropriately manage the ABC’s or treatment for shock.

– Failure to assess transportation priority.– Failure to treat threats to the ABC’s before

doing the Secondary Survey.