STS: Rapid Trauma AssessmentSeptember 17, 2018

Rapid Assessment• Goal: To identify any life threatening injuries that

caused the disturbance or loss of function found during the primary assessment.

– ABC’s, ALOC, etc.

• Use inspection, palpation, auscultation, and smell of certain odors to help uncover findings.

• Head-to-toe rapidly (between 60-90 seconds).

• Order (within assessment) depends on each scenario.

Rapid Assessment

Target Areas

• Head• Neck• Chest• Abdomen

• Pelvis• Upper Extremities• Lower Extremities• Back

Use DCAP-BTLS

• Deformities• C• A• P

• B• T• L• S

Use DCAP-BLTS

• D• Contusions• A• P

• B• T• L• S

Use DCAP-BLTS

• D• C• Abrasions• P

• B• T• L• S

Use DCAP-BLTS

• D• C• A• Penetrations/ Punctures

• B• T• L• S

Use DCAP-BLTS

• D• C• A• P

• Burns• T• L• S

Use DCAP-BLTS

• D• C• A• P

• B• Tenderness• L• S

Use DCAP-BLTS

• D• C• A• P

• B• T• Lacerations• S

Use DCAP-BLTS

• D• C• A• P

• B• T• L• Swelling/ Scars

Use DCAP-BTLS

• Deformities• Contusions• Abrasions• Penetrations/ Punctures

• Burns• Tenderness• Lacerations• Swelling/ Scars

Additional Assessment Elements

– Asymmetry of head and face– Drainage (CSF)– Raccoon eyes– Battle’s sign– Soot/singed nasal or facial hairs– Emesis– Nasogastric tube– Check pupils if they haven’t already been

assessed.

Make sure to maintain patent airway!

Head: skull, eyes, ears, nose, mouth, face

Additional Assessment Elements

– Medical alert tags– Jugular vein distention (JVD)– Tracheal deviation– Carotid pulses (as needed)– Accessory muscle use– Subcutaneous emphysema (crepitus)– Stoma– Tracheostomy– Central venous catheters– Check back of neck for step-offs.

Neck and Cervical Spine:

Additional Assessment Elements

– Paradoxical movement– Accessory muscle use– Sucking chest wound– Subcutaneous emphysema (crepitus)– Pacemaker– Internal cardiac defibrillator– Central catheters– Chest tubes

Chest: clavicles, sternum, ribs

Additional Assessment Elements

DR. GERM

– Distension– Rigidity– Guarding– Evisceration– Rebound tenderness– [Pulsating] mass

• Do not palpate!

Abdomen: palpate all 4 quadrants

– Signs of pregnancy– Gastrostomy tube– Colostomy– Medication pumps

Additional Assessment Elements

– Incontinence– Priapism– Vaginal bleeding– Urinary catheter

Pelvis: assess stability

ExtremitiesApply alternating pressure down the entire length of limb. Check hands and feet.

• Upper Extremities– Check CMS (brachial/radial pulse)– Track marks– Medical alert tags– Arteriovenous (AV) shunt or fistula– Crepitus

• Lower Extremities– Check CMS (pedal or posterior tibial pulse)

• Pedal pulse -->Mark it• Crepitus

BackRun fingers along spine, checking all vertebrae. Make sure to properly log roll patient if supine (maintaining C-spine if necessary) or to keep one arm in front of patient if Fowler’s.

– Step-offs– Sacral edema– Exit wounds– Melena

Plan for STS

• Demo of Rapid Trauma (active)

• Practice Rapid Trauma with a partner

• Rapid Trauma with E-Team member before you

leave