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Principles of Patient Assessment in EMS

Principles of Patient Assessment in EMS . By: Bob Elling, MPA, EMT-P & Kirsten Elling, BS, EMT-P. Chapter 8 – Rapid Trauma Exam. © 2003 Delmar Learning, a Division of Thomson Learning, Inc. . Objectives.

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Principles of Patient Assessment in EMS

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  1. Principles of Patient Assessment in EMS By: Bob Elling, MPA, EMT-P & Kirsten Elling, BS, EMT-P

  2. Chapter 8 – Rapid Trauma Exam © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

  3. Objectives • Describe when it is appropriate for the EMS provider to perform the rapid trauma exam (RTE). • Explain the objectives of the rapid trauma exam (RTE). • Describe how DCAP-BTLS is used during the RTE. • Explain the steps of the RTE. © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

  4. Objectives (continued) • Explain why it is necessary to remove various clothing during the RTE and what considerations should be taken in removing any clothing. • List several examples of significant MOI. © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

  5. Introduction • RTE is quickly accomplished on the scene • In rare occasions the RTE may be completed in the ambulance: • Environmental issues (i.e.: snow, rain) • IA problems that are unresolved © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

  6. Rapid Trauma Exam • Quickly examine: • Head • Neck • Chest • Abdomen • Pelvis • Extremities • Back/buttocks • Continue manual spinal immobilization throughout • Assess for DCAP-BTLS © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

  7. The “DCAP-BTLS” Acronym • D – deformity • C – contusions • A – abrasions • P – penetration/punctures • B – burns • T – tenderness • L – lacerations • S – swelling • Crepitation and auscultation as appropriate © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

  8. Steps in the RTE • BSI precautions • Remove clothing as appropriate (environment, privacy) • Reconsider MOI • Head/neck • Chest – auscultate • Abdomen – 4 quadrants • Pelvis • Extremities – distal PMS • Posterior – have the board ready © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

  9. MOI Examples • Feet-first impact • Head-first impact • Fall on outstreched arm • Fall on or twisting of the knee • Up and over the dashboard • Down and under the dashboard • Lateral impact • Coup-contra coup head injury © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

  10. MOI Examples • Penetration by high velocity projectile • Injury suggestive of underlying injuries • Physical abuse • Waddell’s triad • Blow to the side of the head • Ejection from vehicle • Partial ejection © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

  11. Conclusion • If significant MOI the RTE is done • Sequential evaluation of the: head/neck, chest, abdomen, pelvis, extremities, and posterior • Time is important! • Be quick and accurate • Practice, practice, practice! © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

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