Post on 03-Apr-2018
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Patient Assessment
UCLA Center for Prehospital Care
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Count the White Shirt Passes
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Patient Assessment and
Management Model
Scene size-up
Primary Assessment (Initial assessment ) CriticalManagement and Transport Decisions
Secondary Assessment
Focused history and physical: Unresponsive Medical / Major TraumaPatient
Focused history and physical: Responsive Medical / Minor Trauma Patient
Detailed physical exam Management of specific Problems or Injury
Reassessment (Ongoing assessment)
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Scene Size-up & Primary
Assessment
Why to find potential life threats
When - upon arrival, pts condition changes, after
interventions
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Scene Size-up
Assess for:
Personnel / Patient Safety with BSI Environmental hazards
Number of patients
Mechanism of injury Additional resources / special equipment
Need for extrication / spinal immobilization
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Scene Size-up
Assess for:
Personnel / Patient Safety with BSI
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Safety to include the use ofPersonal Protective Equipment
(PPE)
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Safety to include the use ofPersonal Protective Equipment
(PPE)
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Scene Size-up
Assess for:
Environmental hazards
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Scene Size-up
Assess for:
Number of patients
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Scene Size-up
Assess for:
Mechanism ofinjury
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Scene Size-up
Assess for:
Mechanism ofinjury
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Scene Size-up
Assess for:
Mechanism ofinjury
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Scene Size-up
Assess for:
Mechanism ofinjury
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Scene Size-up
Assess for:
Mechanism ofinjury
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Scene Size-up
Assess for:
Mechanism ofinjury
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Scene Size-up
Assess for:
Mechanism ofinjury
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Scene Size-up
Assess for:
Mechanism ofinjury
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Scene Size-up
Assess for:
Mechanism ofinjury
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Scene Size-up
Assess for:
Additional resources / special equipment
Need for extrication / spinal immobilization
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Scene Size-up
Assess for:
Personnel / Patient Safety with BSI Environmental hazards
Number of patients
Mechanism of injury
Additional resources / special equipment
Need for extrication / spinal immobilization
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Primary Assessment
General impression
Life-threatening conditions
Patient Rapport
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Primary Assessment
Assess/manage:
AVPU/Spinal Considerations Orientation as appropriate (Person, Place,
Time, Event)
Airway
Breathing
Circulation
pulses
skin signs
obvious bleeding
Intervene whenevernecessary!!!
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Primary Assessment
Disability/Deformity:
Altered mental status
Obvious neurological deficits
Abnormal body presentation (posture)
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Subtle Signs of Hypoxia
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Primary Assessment
Determine:
Chief complaint / problem
Big Sick vs. Little Sick.
Make a transport decision
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Initial Contact / Primary Assessment
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Initial Contact / Primary Assessment
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Initial Contact / Primary Assessment
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Initial Contact / Primary Assessment
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Initial Contact / Primary Assessment
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Secondary Assessment
Two approaches based on patients chief complaint: responsive medical / minor trauma
unresponsive medical / major trauma
To Include: Neuro Exam if ALOC
History of chief complaint (OPQRST, AEIOUTIPS)
History of patient (SAMPLE)
Vital signs
Detailed or pertinent physical exam
Reassessment
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The goal is to identify the life threatening injuries thatcaused the disturbance or loss of function found
during the primary assessment . Airway, breathing, circulation, or acute change in mental
status
Use inspection, palpation, auscultation, and thesmell of certain odors to help you uncover thesefindings.
Head to Toe, Rapidly
Rapid Assessment
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Deformities
C
A
P
B
T
L
S
Use of the DCAP-BTLS mnemonicwill help you recall important
indications of trauma
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D
Contusions
A
P
B T
L
S
DCAP BTLS
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D
C
Abrasions
P
B T
L
S
DCAP BTLS
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D
C
A
Punctures &
Penetrations
B T
L
S
DCAP BTLS
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D
C
A
P
Burns
T
L
S
DCAP BTLS
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D
C
A
P
B
Tenderness
L
S
DCAP BTLS
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D
C
A
P
B
T
Lacerations
S
DCAP BTLS
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D
C
A
P
B T
L
Swelling
DCAP BTLS
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Rapid Assessment
http://localhost/var/www/apps/conversion/tmp/scratch_2/Rapid%20Trauma%20Assessment.mov7/28/2019 Patient Assessment Without Review Questionsv2
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Detailed / Pertinent Physical Exam
Head
Neck
Chest
Abdomen
Pelvis
Legs
Arms
Back
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Physical Exam - Head
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Physical Exam - Head
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Physical Exam - Head
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Physical Exam - Head
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Physical Exam - Head
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Physical Exam - Neck
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Physical Exam - Neck
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Physical Exam - Neck
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Physical Exam - Chest
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Physical Exam - Chest
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Physical Exam - Abdomen
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Physical Exam - Abdomen
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Physical Exam - Pelvis
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Physical Exam - Legs
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Physical Exam - Legs
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Physical Exam - Arms
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Physical Exam - Arms
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Physical Exam - Back
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Detailed Body Check
http://localhost/var/www/apps/conversion/tmp/scratch_2/Detailed%20Physical%20Exam.mov7/28/2019 Patient Assessment Without Review Questionsv2
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Reassessment
Repeat initial assessment
Repeat relevant portion of thefocused exam
This is repeated:
Every 5 minutes for priority patients
Every 15 minutes for stable patients
Evaluate response to treatment
Compare results to baseline