Chapter 4 Finding out What's Wrong
Transcript of Chapter 4 Finding out What's Wrong
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Chapter 4Finding Out What’s Wrong
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Victim Assessment Overview (1 of 2)
• Knowing what to do and what not to do is crucial during an emergency.
• A victim assessment is a sequence of actions that helps determine what is wrong.
• A primary check will determine if:• there is illness or injury.• whether the victim is responsive or
unresponsive.• if a life-threatening condition exists.
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Victim Assessment Overview (2 of 2)
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Assessment Steps
• Scene size-up• Primary check• Secondary check• SAMPLE history• Reassessment
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Scene Size-Up
• Look for hazards.• Notice the potential for violence.• Be observant of weapons.• Reduce exposure to potentially
dangerous body substances.• Determine whether the problem is
an injury or an illness .
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Primary Check (1 of 2)
Identify life-threatening conditions so that you can immediately take action to treat the conditions. •Responsiveness•Circulation•Breathing•Severe bleeding
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Primary Check (2 of 2)
Form a first impression.• Injury or illness?• Responsive or unresponsive?• Breathing adequately?• Talking?• Bleeding?• Chance of exposure to blood or body fluids?• Danger to you, victim, or bystanders?
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Check Responsiveness
• Tap the victim on the shoulder and ask, “Are you okay?”
• Use the AVPU scale.
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Alert Victim
• Evaluate ability to remember.• What is your name?• Do you know where you are?• What are the month and year?• What happened?
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An Unresponsive Victim RAP-CAB (1 of 4)
R = Responsive? Tap shoulder and shout, “Are you okay?”
Courtesy of Berta A. Daniels, 2010
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An Unresponsive Victim RAP-CAB (2 of 4)
A = Activate emergency medical services (EMS)
Courtesy of Berta A. Daniels, 2010
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An Unresponsive Victim RAP-CAB (3 of 4)
P = Position the victim on his or her back. C = Cardiopulmonary resuscitation (CPR)Start with 30 chest compressions if the victim is not breathing.
Courtesy of Berta A. Daniels, 2010
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An Unresponsive Victim RAP-CAB (4 of 4)
A = AirwayOpen the airway.
B = BreathsGive two breaths and continue CPR. Courtesy of Berta A. Daniels, 2010
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A Responsive VictimRAP-ABC
R = ResponsivenessA = Activate EMSP = PositionA = AirwayB = BreathingC = Circulation
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Check for Breathing
• Chest movement• Normal and
abnormal breath sounds
• Feeling adequate air movement
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Check for Severe Bleeding
• Check for a large amount of blood. • Around the victim• On the victim’s clothing
• Control bleeding. • Wear exam gloves.
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Position the VictimMost victims should not be moved. •Exceptions:
• Unsafe location• Victim is face down and needs CPR.• Victim has difficulty breathing from vomit or
secretions.• First aider is alone and must leave to get
help.
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High Arm IN Endangered Spine (HAINES) (1 of 2)
• Keep left arm straight, extended above the head with upper part of the arm next to the head.
• Bring right arm across the chest.• Place back of right hand against the left
cheek and hold it there.
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High Arm IN Endangered Spine(HAINES) (2 of 2)
• Bend the far leg at the knee and pull the bent leg to roll the victim toward you.
• Head stays on left arm while rolling.• Right hand stabilizes the head.• Right bent knee prevents rolling.
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Left Side Advantages
• Keeps the airway open• Delays vomiting• Delays a poison’s effect• Relieves pressure on a pregnant
woman’s vena cava
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Secondary Check (1 of 2)
• Determine whether the cause or mechanism of injury was significant.
• Assume a victim with a head injury also has a spinal injury.
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Secondary Check (2 of 2)
• For a responsive victim:• Ask if he or she can feel or wiggle the
fingers and toes.• For an unresponsive victim:
• Check spinal cord with Babinski reflex test.
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Signs and Symptoms
Signs • See• Feel• Hear• Smell
Symptoms• Things the victim
feels• Things the victim
can describe• Chief complaint
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DOTS
D = DeformityO = Open woundsT = TendernessS = Swelling
© Johnathan Noden-Wilkinson/ShutterStock, Inc.
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Significant Cause of Injury (1 of 5)
• Check the head.• Check eyes
(PERRL).• Check the ears.• Check the nose.• Check the mouth.
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Significant Cause of Injury (2 of 5)
• Check the neck.• Check the chest.
• Gently press inward.
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Significant Cause of Injury (3 of 5)
• Check the abdomen.• Gently press on
all four quadrants.
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Significant Cause of Injury (4 of 5)
• Check pelvis. • Gently press
downward on tops of hips.
• Press downward.
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Significant Cause of Injury (5 of 5)
• Check extremities.• Circulation• Sensation• Movement
• Check back.
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Special Considerations (1 of 4)
• Skin condition• Color• Temperature• Moisture
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Special Considerations (2 of 4)
• Capillary refill test• Press fingernail or
toenail for a few seconds and release.
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Special Considerations (3 of 4)
• Expose injury.• Explain what you
are doing.• Maintain privacy.• Prevent exposure
to cold.
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Special Considerations (4 of 4)
• Check the following for medical identification tags:• Wallet• Purse• Necklace• Bracelet
Courtesy of the MedicAlert Foundation ®
Courtesy of the MedicAlert Foundation ®
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SAMPLE History
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Recheck
• Serious illness or injury: every 15 minutes
• Unresponsive victim: at least every 5 minutes
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Triage
Process of prioritizing multiple victims
• Immediate care• Delayed care• “Walking wounded”• Dead