Patient Assessment And Management

1. Patient Assessment And Management By Ethan Bjorklund Dave Furey Grant Riedemann IV SKILL STATION 1 IHCC EHS REVIEW

2. 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.

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

4. 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.

5. 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

6. 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.

7. 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

8. Expose (continued) • B-bruising • T-tenderness • L-lacerations • S-swelling

9. 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

10. 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.

11. 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.

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

13. 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.

14. ABDOMEN/PELVIS • Inspect and palpate abdomen for any signs of DCAP-BTLS. • Assess pelvis for and signs of DCAP-BTLS.

15. 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

16. 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

17. POSTERIOR THORAX/LUMBARBUTTOCKS • Inspect and palpate posterior thorax, lumber, and buttocks areas for any signs of DCAP-BTLS. • Identify and treat minor wounds/fractures appropriately.

18. 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.

19. 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.