1. Patient Assessment

2. Scene Size - Up Scene safety / BSI
Mechanism of injury / Nature of the illness
Number of patients
Consider need for additional manpower or specialized resources

3. Primary Survey Goal of primary assessment
To identify and initiate treatment of immediate or potentially life threatening problems
Whether the patient’s Chief Complaint is trauma or medical related we begin with the primary assessment.

4. Primary Assessment Steps
Form a general impression
Introduce yourself and ask for patients chief complaint
Determine patients Level of Consciousness
Conscious unaltered LOC
Conscious with altered LOC
Unconscious
AVPU
Glascow Coma Scale

5. Glasgow Coma Scale

6. Airway Responsive Patient Unresponsive Patient
Are they talking to you or crying?
Does patient exhibit any signs of dyspnea?
Is breathing noisy?
Unresponsive Patient
Assume trauma unless confirmed not to be trauma related
Open airway with either modified jaw thrust or head tilt chin lift
Address foreign body obstruction
Apply airway adjuncts if indicated
Suction if indicated
Assist ventilations if needed
If airway is clear, move to next step

7. Breathing Is spontaneous breathing present?
Is breathing adequate or inadequate?
How do we tell the difference?

8. Circulation Does patient have a pulse
Carotid
Radial
Brachial (pediatric)
Femoral
Any bleeding that needs to be controlled
Skin condition

9. Decision Time After primary assessment we decide
Does this patient have a medical problem?
Does this patient have trauma injuries?
Does this patient have both?
Is this patient a load and go?
Do we need ALS support

10. Load and Go Patients Rapid trauma assessment
Head to toe exam while maintaining C spine stabilization
Note any obvious findings
Assess any areas that will be inaccessible after immobilization (Neck / Back)
Support and treat any life threats

11. Assessment Acronyms
DCAP BLS TIC
OPQRST
SAMPLE
FAST
GEMS Diamond

12. Assessment Tools BP Cuff Stethoscope Pulse Oximeter Pen light
Glucometer
AED
Senses
Look listen and feel

13. Trauma Patient Once loaded and enroute start secondary assessment
Head to toe using DCAP BLS TIC
Assess any previous treatments performed
Bandaging and splinting
Note any abnormal findings
Notify medical command of assessment and ETA

14. Key Point
Trauma patients may have an underlying medical problem that is exacerbated by the injury OR
A Medical problem may have resulted in a traumatic injury

15. The Medical Patient Focus assessment on chief complaint
Cardiac
Respiratory
Abdominal complaints
Neurological complaints
Perform interventions as indicated
Notify medical command of findings, treatment, and ETA

16. Reassessment Every 5 minute for unstable patients
Every 15 minute for stable patients

17. Changes in Condition Check previous interventions
Start over with primary assessment

18. Assessment Challenges
Geriatrics
Pediatrics
Special needs patients
Language barrier
Multiple patients

19. Skills Practice
Review hands on assessments both medical and trauma using WVOEMS approved skills sheets as a guide