Take Action in an Emergency - Victim Assessment

Document Sample
Take Action in an Emergency - Victim Assessment Powered By Docstoc
					Taking Action In An
     Emergency:
 Initial Assessment
You have just arrived at the
site of an emergency.

What should you do first?
Step 1: Survey The Scene
(check the scene)

 Piece together the puzzle
 Look for dangerous hazards
 Quickly determine:
  • The number of victims
  • The cause of injury
  • Are there witnesses?
Survey The Scene #2
 Do not approach the victim if
 threat exists
Survey The Scene #3
 Attain   consent
  • Gain victim’s confidence
  • Identify problems
  • Don’t assume that the injury
    you see is the only one
  • Gather info that will be helpful
    to EMS
Survey The Scene #4
 Remain calm
 Call EMS if needed

Do not move the victim
 unless it is necessary to
 support life or life threat
 exists
Step 2: The Initial Victim
Assessment
   Identify and correct life threatening
    conditions related to
    •   Airway
    •   Breathing
    •   Circulation
    •   Disablity
Goal of the Initial Assessment
 Toassess heart, lung, brain and
 spinal cord functioning (address life
 support – does the victim need
 CPR?)
  • Cardio Pulmonary Resuscitation
       – Cardio refers to heart
       – Pulmonary refers to lungs
       – Resuscitate refers to revival
How To Proceed Through The
Initial Assessment:
RAPABCD
R    - check for responsiveness
  •   A – alert
  •   V – responds to voice
  •   P – responds to pain
  •   U – unconscious, no responses
A  - activate EMS (911)
 P - position victim on the back
How To Proceed #2:
RAP ABCD
(checking for vital signs - pulse
and respiration)

    A - Airway
    B - Breathing
    C - Circulation
    D – disability
Airway
 Open   the airway by “head tilt, chin
  lift”
 If spinal cord injury is suspected, be
  more cautious
Breathing
 Look, listen, and feel for   breathing
  (no more than 10 seconds)
Circulation
   Check for major bleeding

    • No longer required to check for
      pulse
Secondary Assessment:
History and Physical Exam

 Head to toe for major injury
 or unresponsive
 • Minor injury, examine
   complaint only
 • More regarding head to toe
   exam will follow
The Secondary Assessment
 Identifyyourself
 Obtain consent
 Ask and use the victim’s name
 Ask about chief complaint
 Use SAMPLE to help you
  remember questions to ask the
  victim
Questions To Ask:
SAMPLE
S   - symptoms
 • symptom: something the victim
   tells the first aider
 • sign: something the first aider
   sees, hears, or feels
A   - Allergies
Sample #2

M   - Medication
 P - Pre-existing illnesses
 L - Last food (food poisoning?
  hypoglycemia?)
 E - Events prior to the injury
The Secondary Assessment
 Systematically look and feel (LAF)
 Look for: DOTS
    •   D - deformity
    •   O - open wounds
    •   T - tenderness
    •   S - swelling
   Start with the head for adults, feet for
    children
Check The Head
 DOTS
 Feelboth sides of the head
 CSF fluid (clear fluid from ear or
  nose / halo effect)
 Check Eyes: PEARL

 Are pupils equal and react to light?
 Use flashlight or cover one eye with a
  hand
 Pupils normally contract in one second
 No pupil reaction could mean death,
  coma, cataracts, artificial eye
Check Eyes #2
 Pupildilation occurs within 30-
  60 seconds of a cardiac arrest
 Look for unequal pupils (stroke,
  head or brain injury)
 Check inner eye lid: it should be
  pink
Check Neck and Chest
 Check  for cuts, bruises,
  compare sides
 Apply slight pressure to
  sides of chest (checking for
  broken ribs)
Abdomen
 Ask if pain is present
 If pain is present, gently press on
  opposite side of pain site to help
  determine area affected
 Feel for lumps
 Feel the 4 abdominal quadrants
Pelvis
Gentlypress downward
 and squeeze inward
Extremity Assessment
 Check   arms and legs
 • deformity
 • tenderness
 • Check for :
   –C - Circulation (pulse sites)
   –S - Sensation
   –M - Movement
Extremity Assessment #2
 Compare   extremities
 • Check temperature of the
   extremity
 Check   nail bed
 • instant refilling means good
   circulation
 • normal refill time is < 2 seconds
Spine and Back
 Askvictim about movement in
 extremities
 Wiggle fingers, toes
 Have victim press foot against your
  hand
 Have victim squeeze your hand
 Babinski reflex test
  • Injured? Big toe flexes upward
 Check for a Medical
     Alert Tag
 24 hour emergency phone
  number
 Do not remove tag unless
  absolutely necessary
Reassess ABC’s:
 Every 5 minutes if unconscious
 or serious injury
 Otherwise, every 15 minutes if
 conscious
Role Play Secondary Survey
   Lab Activity
Is There a Head or Spinal
Injury?
 Always stabilize the head immediately
 Signs of Spinal Cord Injuries
    • Painful movement of arms and legs
    • Numbness, tingling, weakness, burning,
      lessened sensation in arms or legs
    • Loss of bowel or bladder control
    • Paralysis of arms or legs
    • Deformity
Always Remember!
RAPABCD
Post Emergency Numbers
Near The Telephone
 Fire department
 Police
 Ambulance or EMS (paramedics)
 Physician
 Poison Control Center
Have You Ever Called 911?
Calling Emergency Medical
Services (EMS - 911)
A    two minute delay in calling EMS
  can be deadly
 If in doubt, call EMS
 Questions by dispatchers are not to
  question the need of the call but to
  determine the level of need
What To Tell 911
Dispatcher
 First,speak slowly and clearly
 When calling from a cell phone,
  give the address immediately
 Listen carefully to the
  dispatcher
Tell The Dispatcher :
 •   Location
 •   Telephone number
 •   What has happened
 •   Number of persons needing help
 •   Special conditions
 •   Your assessment of the victim
 •   Do not hang up unless the dispatcher
     instructs you to