1. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ CHAPTER 7 Scene Size-Up

2. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Overall Assessment Scheme Scene Size-Up Initial Assessment TraumaMedical Physical Exam Vital Signs & SAMPLE History Physical Exam & Vital Signs Detailed Physical Exam OngoingAssessment HOSP

3. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Scene Size-Up K ey Term Determining any threats to your own safety or to the safety of your patients or bystanders, to determine the nature of the call, and to decide if you will need additional help

4. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Scene Safety

5. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Scene Safety An assessment to assure the well- being of the EMT–Basic K ey Term

6. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Scene Safety Protect bystanders (prevent them from becoming patients). Never enter an unsafe scene. Make scene safe or call for someone who can.

7. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Minimum 50 around scene, further if: Fuel spill Fire Hazardous materials Downed power lines Danger Zone

8. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Crash or Rescue Scenes

9. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Toxic Substances or Hazmat

10. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Unstable Surfaces: Unstable Surfaces: Slopes, Ice, Water

11. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Use scene clues: Fighting Loud voices Alcohol/drug use Unusual silence Prior experience Scene Violence

12. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Crime Scenes and Violence

13. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Body Substance Isolation

14. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Body Substance Isolation Anticipate the need for BSI. Always have BSI equipment available. Use appropriate equipment to prevent exposure.

15. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ BSI Review: Gloves

16. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ BSI Review: Mask and Eye Protection

17. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ BSI Review: Gown

18. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Mechanism of Injury/ Nature of Illness

19. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Mechanism of Injury The physical event that caused an injury (fall, motor vehicle accident, etc.) K ey Term

20. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Mechanism of Injury Determined from: Patient Family Bystander Observation of the scene

21. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Mechanism of Injury: Motor Vehicle Collision–Head On

22. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Mechanism of Injury: Motor Vehicle Collision–Rear Impact

23. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Mechanism of Injury: Motor Vehicle Collision–Side Impact

24. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Mechanism of Injury: Motor Vehicle Collision–Rollover

25. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Rotational May have multiple impacts Mechanism of Injury: Motor Vehicle Collision–Rotational

26. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Ejection Deformed windshield, steering wheel, etc. Amount of vehicle deformity Seat belt use Mechanism of Injury: Motor Vehicle Collision

27. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Mechanism of Injury: Motor Vehicle Collision–Vehicle Interior

28. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Motorcycles All-terrain vehicles Snowmobiles Jet-Ski Mechanism of Injury: Motor Vehicle Collision–Motorized Vehicle

29. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Mechanism of Injury: Mechanism of Injury: Falls

30. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Distance patient fell Part of body that struck surface Type of surface landed on Did anything break the fall? Mechanism of Injury: Falls

31. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Velocity Low velocity–knife Medium velocity–handgun, shotgun High velocity–rifle Body region penetrated Exit wounds Mechanism of Injury: Penetrating Trauma

32. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Mechanism of Injury: Mechanism of Injury: Penetrating Trauma

33. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Mechanism of Injury: Mechanism of Injury: Blunt Force Trauma

34. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Nature of Illness: Medical Patient Sources of Information Scene Patient Family and bystanders

35. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Adequacy of Resources

36. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Adequacy of Resources Number of patients? Hazardous materials? Fire or rescue? Unusual situations?

37. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ Adequacy of Resources Call for assistance before beginning care. Use triage procedures if necessary.

38. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ 1. Why must BSI be considered during the size-up? 2. List several factors which may make a scene unsafe. 3. Describe ways to determine information about the nature of medical emergencies. Review Questions

39. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ 4. For each of the following mechanisms of injury, list several things to look for or consider: Falls Motor vehicle accidents Penetrating trauma Review Questions

40. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ What other scene size-up issues are still left to consider? Is the scene now safe, or do other precautions need to be taken? What BSI precautions should be considered? S TREET S CENES

41. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ When the second ambulance arrives, where should it be located in relation to the collision scene? S TREET S CENES

42. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ What precautions should you take to protect the patient from any further harm while they are being extricated from the vehicle? S TREET S CENES

43. Limmer et al., Emergency Care, 10 th Edition © 2005 by Pearson Education, Inc. Upper Saddle River, NJ How should you plan to make sure that you can safely get the patient from the scene to the ambulance? S TREET S CENES