What is Trauma? A serious injury or shock to the body by violence or accident!
Trauma Assessment is a Basic life support skill!
Touching the patient is a must to find possible injuries!
What are we looking for? Life threats that are going to kill the patient right now! Any obvious injuries that the patient has Any underlying injuries the patient may have we can’t see Changes that may occur during transport
Now let’s take a look at how the assessment should go!
Scene size-up This is the overall picture of the scene to ensure the safest environment for yourself, your crew, other responding personnel, patient, and bystanders in that order.
Scene size-up BSI (body substance isolation) Scene safety Number of victims Other help or equipment needed Mechanism of injury
Mechanism of Injury Predictable pattern of injuries caused by forces applied to the body Helps you key in on possible injuries
Initial assessment General impression- your gut feeling on patient status and priority of transport LOC- AVPU on patient with simultaneous initiation of c-spine immobilization Airway- open/clear if not fix it Breathing- rate/quality interventions to airway- oxygen by NRB or BVM Circulation- compare radial vs. carotid pulses, skin color/temp/condition Control any major bleeding!
Decisions, decisions, decisions Load and Go or Stay and play Rapid trauma survey Focused trauma survey
Rapid Trauma assessment Should take less than two minutes to perform A quick scan of whole body Identifies any life threats Used to mentally note injuries to fix later
HEAD Palpate the head looking for DCAP-BLS-TIC Examine the facial bones Look at ears, nose, and mouth for any fluids coming from them Check for Battle signs or raccoon eyes
Neck Visualize neck for DCAp-bls-tic Check neck for tracheal deviation Check neck for Jugular vein distention Palpate the back of the neck Consider applying the c-collar
Chest Visualize chest for DCAP-bls-tic Listen to breath sounds(this is a bls skill) Palpate the chest IF a open wound or flail chest is found have a partner place a gloved hand over area till you finish rapid trauma survey
Abdomen Visualize the abdomen for dcap-bls-tic Palpate abdomen for rigidity, guarding, or tenderness If patient alert and tells you where pain is feel that area last
Pelvis Palpate the pelvis for dcap-bls-tic It is a in and down motion Do not rock the pelvis If you find a unstable pelvis do not mess with it again
Lower extremities Visualize lower extremities for dcap-bls- tic Palpate down one leg at a time Check for pulse, motor, sensory function to both feet Check for capillary refill
Upper extremities Visualize upper extremities for dcap-bls- tic Palpate both arms Feel for pulse, motor, and sensory Check capillary refill
Back Log roll the patient with c-spine stabilization Visualize back for dcap-bls-tic Palpate back from neck to legs
Secure patient to board Secure body first Then secure head Reassess PMS after moving patient Securing head first or not securing body could be a major problem if patient becomes sick and you have to roll patient to maintain airway!
Attempt to obtain sample history Signs/symptoms Allergies Medicines including OTC and herbal Pertinent past medical history Last oral intake not just eating Events leading to trauma
Now the patient is in the ambulance enroute to the hospital!