PE-0131 Lecture Notes - Lecture 4: Wound, Bruise

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PE - 131
2/1/17
Patient Assessment
Patient Assessment (basic linear sequence of events)
1. Dispatch - What is the call? Is ALS responding?
2. Arrival - Is the scene safe? Are your resources adequate?
3. Approach - how is the patient? Still vs. moving? Large pools of fluid? Noises? Skin
color? Are limbs how they should be?
4. Primary Survey - life threatening injuries? Priority patient? Airway, Breathing, Circulation
5. Secondary survey (includes history taking)
6. Reassessment
Symptom - subjective condition that the patient describes/tells you about
Sign - something that you can see
Scene Size-up
How you prepare for a specific situation
Begins with dispatcher’s basic information
Combined with an inspection of the scene
Body Substance Isolation (Personal Protective Equipment)
Assume all body fluids present a possible risk for infection
Protective equipment - gloves, eye protection, mask, and gown
Treat everyone as though they are infected
Ensure Scene Safety
Wear a public safety vest
Look for possible dangers as you approach the scene
Typically enter the area in the same way in which you leave (crime scene type thing)
Also what you take in with you, you take out with you
Ensure your own safety first and the patient's second
Watch out for…incoming traffic, unstable surfaces, leaking gasoline, downed electrical
lines, potential violence, fire or smoke, hazardous materials, other dangers, and crime
scenes
If the scene is unsafe make it safe, if you can’t make it safe stay out
Determine Mechanism of Injury/Nature of Illness
To care for trauma patients you must understand the mechanism of injury (MOI)
MOI (evaluate) - amour of force applied to body, length of time force was applied,
area of body involved
What happened to them?
Significant MOI!
Ejection from vehicle
Death of passenger in
compartment
Fall greater than 15’-20’
Vehicle rollover
High-speed collision
Vehicle-pedestrian collision
Motorcycle crash
Unresponsiveness or altered
mental status!
Fragile injuries - brain, spinal cord, and eyes
For medial patients, determine the nature of illness (NOI)
Search for clues to determine the nature of the illness
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