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Outdoor Emergency Care. -wrap up. Class Tonight. The Big Picture. Advanced Patient Assessment. Packaging Transportation. Experience Confidence in applying skills. Advanced Patient Assessment. Rescuer Readiness Scene Survey & Environmental Safety Primary Assessment
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Outdoor Emergency Care -wrap up
Class Tonight • The Big Picture • Advanced Patient Assessment • Packaging • Transportation • Experience • Confidence in applying skills
Advanced Patient Assessment • Rescuer Readiness • Scene Survey & Environmental Safety • Primary Assessment • Secondary Assessment: Trauma Patient • Secondary Assessment: Medical Patient • On-Going Assessment & Monitoring
Rescuer Readiness • Patient assessment starts before you get to the patient • Reviewing Dispatcher Information • What to expect • Location • Do you know where you are going? • Potential problems at the location
Scene Survey & Environmental Safety • Note Expressions of Bystanders • Identify Hazards • Determine Special Needs • Evaluate Mechanism of Injury • Evaluated Scene Safety
Body Substance Isolation (BSI) • “If it is warm, wet, and was in them; don’t get it on you.” –Douglas Dagan
Primary Assessment • Covering The ABCs • Goals of the Primary Assessment
Primary Assessment: The ABCs • A: Airway Assessment & Management • B: Breathing Assessment & Management • C: Circulation Assessment & Management
Primary Assessment: The Goals • Detect Immediate Life Threats • Treat Life-Threatening Conditions • Assess Need For Rapid Transportation
Secondary Assessment • Goals of Secondary Assessment • Methods of Physical Examination • Methods of Developing Patient History • Trauma Assessment • Medical Assessment
Secondary Assessment: Goals • Complete Head to Toe Exam • Gather Additional Information • Complete Picture of Patient Health Anything Life-Threatening Should be Taken Care of in the Primary Survey
Secondary Assessment:Physical Exam • Inspection -Examination by Sight • Obvious Deformities & Abnormalities • Palpation -Examination by Touch • Need Kinesthetic Vocabulary • Auditory -Examination by Hearing • Respirations and Perfusion
Secondary Assessment:Patient History (SAMPLE) • Introduction • Chief Complaint • Focused Pertinent History • Trauma: DECAP-BTLS • Medical: OPQRST • Past Trauma/Medical History • Family & Social History
DECAP-BTLS D: Deformities C: Contusions A: Abrasions P: Punctures, Penetrations B: Burns, Bleeding T: Tenderness L: Lacerations S: Swelling Vital Signs Head Ears Eyes Face Nose & Mouth Neck Chest & Back Secondary Assessment: Trauma • Abdomen • Pelvis • Lower Extremities • Upper Extremities • Neurological
OPQRST O: Onset P: Provocation Q: Quality R: Radiation S: Severity T: Time Recognize The Seriousness of Illness Patient History Is Key Good Record Keeping SOAP: Subjective, Objective, Assessment, Plan Secondary Assessment: Medical
Ongoing Assessment And Monitoring • Continue To Communicate • Reassess Often • Vitals
Scene Size-Up Initial Assessment Responsive Unresponsive Medical Trauma Focused Medical History AND Physical Exam Focused History AND Physical Exam Rapid History AND Physical Exam Transport Detailed Physical Exam Ongoing Assessment
Packaging the Patient Goals of Packaging Environmental Conditions Patient Comfort Physical Psychological Packaging
Patient Packaging: Goals • To Prepare Patient For Transport • Or For Extrication • Stabilize Injury and Patient • Maximize Access to Injured Area • Secure Patient • Secure Extremities
Patient Packaging: Environmental Conditions • Maintain Body Temperature • Protect From Elements • Exposed Skin
Patient Packaging:Comfort • Maximize Patient Comfort • Physical & Psychological • Communicate With Patient
Transporting The Sick & Injured • Role of Emergency Medical Providers in the Medical System • Goals of Effective Transportation
Transportation: Our Role • The Fundamental Basis of What We Do • Stabilize and Transport
Transportation: Goals • Identify The Need For Rapid Transport • Deliver Stable Patient Advanced Care • Smooth Transition Between Wilderness and Street EMS Personal
Review of Transportation • Will Be A Part of Virtually Every Scene We Work • Identify Rapid Transport Patients • Monitor and Reassess Patient Stability • Protect Patient From The Elements • Transition to Street EMS
Summary of Tonight’s Class • The Big Picture • Advanced Patient Assessment • Packaging Transporting The Sick and Injured