Emergency Response American Red Cross Instructor: Joel Bass MS ATC 1995 USDOT First Responder Curriculum

Assessment I

Scene Size-up Main components of a scene size-up Main components of a scene size-up Scene safety Scene safety Mechanism of injury or nature of illness Mechanism of injury or nature of illness Number of victims Number of victims Resources needed Resources needed

Initial Assessment Video (Performing an Initial Assessment) Video (Performing an Initial Assessment) The initial assessment is performed to identify immediate threats to life.

Initial Assessment The initial assessment has five components The initial assessment has five components Forming a general impression of the victim Forming a general impression of the victim Chief complaint, ill or injured, gender, age… Chief complaint, ill or injured, gender, age… Assessing level of consciousness or mental status Assessing level of consciousness or mental status AVPU AVPU If the victim is responsive, ask for consent to help If the victim is responsive, ask for consent to help If the victim does not respond, Check ABCs If the victim does not respond, Check ABCs Assessing the victim’s airway Assessing the victim’s airway Assessing the victim’s breathing Assessing the victim’s breathing Assessing the victim’s circulation Assessing the victim’s circulation (signs of breathing, movement, coughing, pulse, severe bleeding, and skin characteristics) Levels of Consciousness – AVPU  A lertIs able to respond you.  V erbal Only responds to verbal commands  P ainful Only responds to painful stimulus  U nresponsiveDoes not respond

Airway May require you to open the airway May require you to open the airway A person who is speaking or crying is conscious, has an open airway, is breathing, and has a pulse. A person who is speaking or crying is conscious, has an open airway, is breathing, and has a pulse. The tongue can sometimes block the airway when lying on the back. The tongue can sometimes block the airway when lying on the back. If the victim is unresponsive, open the airway using one of two methods If the victim is unresponsive, open the airway using one of two methods Illness – head-tilt/chin-lift Illness – head-tilt/chin-lift Injury – jaw-thrust Injury – jaw-thrust Inspect and clear the airway of obvious obstruction, such as food or loose dentures. Inspect and clear the airway of obvious obstruction, such as food or loose dentures.

Breathing Look, listen, and feel for breathing. Look, listen, and feel for breathing. Determine whether victim is: Determine whether victim is: Breathing Breathing Breathing distress Breathing distress Not breathing Not breathing If victim is breathing, determine the rate and quality. If victim is breathing, determine the rate and quality. If the victim is not breathing provide rescue breathing. If the victim is not breathing provide rescue breathing. If breaths go in, assess the victim’s circulation If breaths go in, assess the victim’s circulation If breaths do not go in, reassess the airway and the need to clear an airway obstruction If breaths do not go in, reassess the airway and the need to clear an airway obstruction

Circulation Assessing the victim’s circulation includes: Assessing the victim’s circulation includes: Signs of breathing Signs of breathing Coughing Coughing Movement Movement Pulse (radial, brachial, carotid) (rate and quality) Pulse (radial, brachial, carotid) (rate and quality) Severe bleeding Severe bleeding Skin appearance (color, temp., moisture, capillary refill) Skin appearance (color, temp., moisture, capillary refill) A victim who is unresponsive, not breathing, and without a pulse is in cardiac arrest. Perform CPR A victim who is unresponsive, not breathing, and without a pulse is in cardiac arrest. Perform CPR Record and report findings Record and report findings Age, gender, chief complaint, level of consciousness, airway, breathing, and circulation status) Age, gender, chief complaint, level of consciousness, airway, breathing, and circulation status)

Physical Exam and Sample History Video (Performing a Physical Exam and SAMPLE history) Video (Performing a Physical Exam and SAMPLE history) Once the initial assessment is complete and any life- threatening emergencies corrected, begin the physical exam. Once the initial assessment is complete and any life- threatening emergencies corrected, begin the physical exam. The Purpose of the physical exam is to- The Purpose of the physical exam is to- Gather information about the problem Gather information about the problem Identify signs and symptoms Identify signs and symptoms Check victim from head to toe. Check victim from head to toe. Look and palpate for signs of injury Look and palpate for signs of injury DOTS DOTS Take a SAMPLE history Take a SAMPLE history For victims with medical complaints, you can obtain a SAMPLE history before doing the physical exam. For victims with medical complaints, you can obtain a SAMPLE history before doing the physical exam. D eformity O pen injuries T enderness S welling SAMPLE History S ings and symptoms A llergies M edications P ertinent past history L ast oral intake E vents leading up to injury or illness

Ongoing Assessment Continue to assess the victim’s vital signs Continue to assess the victim’s vital signs (consciousness, breathing, and circulation) Repeat the initial assessment Repeat the initial assessment Every 5 min. for the unstable Every 5 min. for the unstable Every 15 min. for the stable Every 15 min. for the stable Repeat the physical exam, if needed Repeat the physical exam, if needed Continue to record all findings Continue to record all findings Turn over findings to EMS. Turn over findings to EMS.

10 Minute Break

Assessment II

Skill Practice: Assessment Bring your skill sheets to the practice area Bring your skill sheets to the practice area Find a partner Find a partner

Activity 1 Initial Assessment Face-up Unconscious Breathing Victim

Activity 2 Initial Assessment Face-up Unconscious Nonbreathing Victim

Activity 3 Perform a Physical Exam Obtain a SAMPLE History

10 Minute Break

Measuring Blood Pressure Video (Measuring Blood Pressure) Video (Measuring Blood Pressure) Systolic Systolic Reflects pressure in arteries when heart is working/contracting Reflects pressure in arteries when heart is working/contracting Diastolic Diastolic Reflects pressure in arteries when heart is resting/relilling Reflects pressure in arteries when heart is resting/relilling

Skill Practice: Measuring Blood Pressure Video (Blood Pressure Practice) Video (Blood Pressure Practice) Bring your skill sheets to the practice area Bring your skill sheets to the practice area Find a partner Find a partner Activity 1: Palpation Method Activity 1: Palpation Method Activity 2: Auscultation Method Activity 2: Auscultation Method

Assignments Reading Assignment: Read Chapter 8 Reading Assignment: Read Chapter 8 Workbook Unit 8 (Turn in at the beginning of class) Workbook Unit 8 (Turn in at the beginning of class)