1. Eight Chapter Assessment of the Trauma Patient

3. Scene Size-Up Initial Assessment Trauma Medical Physical Exam Vital Signs & SAMPLE History SAMPLE History Physical Exam & Vital Signs Detailed Physical Exam Ongoing Assessment HOSP O VERALL ASSESSMENT SCHEME

4. S IGNIFICANT MECHANISM OF INJURY

12. Mechanism of Injury Interior of Vehicle Deformities to a vehicle’s interior may show where person struck the surface and reveal a mechanism of injury. (Continued)

13. Bent Steering Wheel Broken Mirror

14. Distorted Pedals Spiderwebbed Windshield

15. Deformed Dashboard

16. P RECEPTOR P EARL The assessment and management of a trauma patient need to focus on time and patient priority. In some cases, the patient does not have the time available in his/her life for the EMT-B to take a lengthy approach. On patients with significant MOI, try to limit the scene time to a “platinum ten minutes!”

18. Inspect and Palpate for DCAP-BTLS = = = = D C A P Deformities Contusions Abrasions Punctures/ penetrations = = = = B T L S Burns Tenderness Lacerations Swelling

19. Deformities Contusions

20. Abrasions Punctures/penetrations

21. Burns Tenderness

22. Lacerations Swelling

23. Mechanism of Injury

24. Head: DCAP-BTLS + Crepitation

25. Neck: DCAP-BTLS + Jugular Vein Distention and Crepitation

26. Chest: DCAP-BTLS + Crepitation and Breath Sounds (Presence and Equality)

27. Mid-clavicular Mid-axillary Listen to both sides of the chest. Is air entry present? Absent? Equal on both sides? Compare left side to right side.

28. Abdomen: DCAP-BTLS + Firmness and Distention

29. Pelvis: DCAP-BTLS (Compress Gently)

30. Extremities: DCAP-BTLS + Distal Pulse, Sensation, Motor Function

31. Posterior: DCAP-BTLS

33. SAMPLE History Signs and symptoms Allergies Medications Pertinent past history Last oral intake Events leading to problem = = = = = = S A M P L E

34. Interventions and Transport

35. Cervical Collar Sizing and Application STIFNECK TM Rigid Extrication Collar Philadelphia Cervical Collar TM

36. Measure patient’s neck. Measure collar. 1 2 Sizing a Cervical Collar

37. STIFNECK TM Collar — Seated Patient Stabilize head and neck manually. Slide collar up toward patient’s chin.

38. Position front of collar under chin. Wrap collar around back of neck. STIFNECK TM Collar — Seated Patient

39. Secure collar. Rearrange fingers to maintain support. STIFNECK TM Collar — Seated Patient

40. Kneel at patient’s head. Stabilize head and neck. STIFNECK TM Collar — Supine Patient

41. Maintain stabilization. Slide back of collar under patient’s neck. STIFNECK TM Collar — Supine Patient

42. Secure collar. Maintain manual stabilization. STIFNECK TM Collar — Supine Patient

43. N O SIGNIFICANT MECHANISM OF INJURY

49. S TEPS IN THE DETAILED PHYSICAL EXAM

52. = = = = D C A P Deformities Contusions Abrasions Punctures/ penetrations = = = = B T L S Burns Tenderness Lacerations Swelling

53. Head DCAP-BTLS

54. Ears DCAP-BTLS + Drainage

58. Neck: DCAP-BTLS + Jugular Vein Distention and Crepitation

59. Chest: DCAP-BTLS + Crepitation and Breath Sounds (Presence and Equality)

60. Mid-clavicular Mid-axillary Listen to both sides of the chest. Is air entry present? Absent? Equal on both sides? Compare left side to right side.

61. Abdomen: DCAP-BTLS + Firmness and Distention

62. Pelvis: DCAP-BTLS (Compress Gently)

63. Extremities: DCAP-BTLS + Distal Pulse, Sensation, Motor Function

64. Posterior: DCAP-BTLS

65. Perform the steps of the rapid trauma assessment — BUT MORE SLOWLY.

67. 1. Give examples of patients with and without significant mechanism of injury. 2. What do the letters DCAP-BTLS stand for? 3. Which trauma patients should have a detailed physical examination? R EVIEW QUESTIONS