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Patient and Assessment

Patient and Assessment. By Ethan, Steve and Dave. Airway with C-Spine Control. takes or directs manual inline immobilization of the head This is done to prevent any injury to the neck opens and assesses airway This is done to make sure airway is clear of any foreign abject. Inserts adjunct

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Patient and Assessment

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  1. Patient and Assessment By Ethan, Steve and Dave

  2. Airway with C-Spine Control • takes or directs manual inline immobilization of the head • This is done to prevent any injury to the neck • opens and assesses airway • This is done to make sure airway is clear of any foreign abject. • Inserts adjunct • On a unconscious patient, you need to keep the tongue of the back of the throat.

  3. Breathing • Assesses breathing • When you assess breathing you need to listen to the lungs to find out if air is moving. When you do that you should also listen to the sound of the lungs.(i.e.. Gurgles, rails,rasps or any air exchange at all) Also find the rate to determine if you need to bag him. • Initiates appropriate oxygen therapy • This is where you put oxygen on the patient and determine at what rate. • Assures adequate ventilation of the patient. • Manages any injury that may compromise the breathing.

  4. Circulation • Checks pulse • There are three major pulse sites. Visual location • Carotid which is in the neck • Femoral which is in the groin region • Radial which is in the radius of the arm • Assesses the peripheral perfusion • Assess the skin color , temp. of the skin and the condition of the skin. • Controls any major bleeding • If you find any major bleeding stop what you are doing and control it. It might not be a problem now, but if untreated it will be a problem.

  5. Circulation • Takes Vital signs • Blood pressure, pulse and respiration's are the three vitals. • Volume replacement • this is where you determine if you need a IV line in the patient. • If pt. Has lost amount of blood pt needs a line. • If pt is a cardiac pt , he needs a line. • When in doubt, ask Medical Control • Large bore IV’s are for large amount of fluids going in. Like a trauma victim. • Small bore are for possible pt’s that will need medications at the hospital

  6. Performs Neuro Exam • Determine if the patient has any neurological problems. • Use the AVPU scale • A- Alert., is the patient alert and talking to you and aware of his surroundings • P-Pain, does the patient respond to pain • V-verbal, does the patient respond to your verbal commands. • U-unresponsive, is the patient unresponsive .

  7. Expose • This is where you look for DCAP BTLS • D- deformities • C-contusions • A-abrasions • P-punctures and perforations • B-bruising • T-tenderness • L-lacerations • S-swelling

  8. Status • This is where you make the call, stay and play or load on go. This is all the marbles, you need to use your skills and your partners to make the right decision.

  9. SECONDARY SURVEY • If you stay and play there will be time to assess patient further.

  10. HEAD • You should check the mouth, nose, facial area for any DCAP BTLS signs. • The scalp and ears should be palpated also for DCAP BTLS signs. • You should also check the pupils to see if they are equal, round and reactive to light.

  11. NECK • Be sure and check the position of the trachea. Making sure there is NO tracheal deviation. • Check jugular veins for distension. • View and palpate Cervical Spine (C-Spine) for any signs of DCAP BTLS

  12. CHEST/THORAX • View chest/thorax area. Check for any signs of DCAP-BTLS. • Palpate Chest/Thorax area. Check for any signs of flail chest. • Auscultate chest/thorax area. Make sure lung sounds are clear and equal bilaterally.

  13. ABDOMEN/PELVIS • View and palpate abdomen for any signs of DCAP-BTLS. • Assess pelvis for and signs of DCAP-BTLS. Check for crepites.

  14. LOWER EXTREMITIES • View and palpate the LEFT leg for any signs of DCAP-BTLS. • View and Palpate the RIGHT leg for any signs of DCAP-BTLS. • Check Distal Circulation, Motor, Sensory (CMS). Lower extremities

  15. UPPER EXTREMITIES • View and palpate the LEFT arm for any signs of DCAP-BTLS. • View and Palpate the RIGHT arm for any signs of DCAP-BTLS. • Check Distal Circulation, Motor, Sensory (CMS) upper extremities

  16. POSTERIOR THORAX/LUMBARBUTTOCKS • View and palpate posterior thorax for any signs of DCAP-BTLS. • View and palpate lumbar and buttocks area for any signs of DCAP-BTLS. • Identify and treat minor wounds/fractures appropriately.

  17. Critical Criteria • Failure to initiate or call for transport of the patient within 10 minutes. • Failure to take or verbalize Body Substance Isolation Precautions. • Failure to initiate or maintain spinal stabilization. • Failure to provide high concentration O2. • Failure to find and evaluate all conditions related to the ABC’s. • Failure to appropriately manage the ABC’s. • Failure to assess transportation priority. • Failure to treat threats to the ABC’s before doing the Secondary Survey.

  18. The END. • click here for more information

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