1. Lets go back to Assessment We are about to introduce scenarios with a much higher degree of trauma Immediate threats to life (eg internal and external bleeding, respiratory distress, head trauma) Spinal injuries requiring backboards Multiple patients and/or bystanders In what way does the Assessment Flow change to deal with these?

2. First Impressions/ LOC/ ABCs As you approach, take in patients General Appearance. - -Skin signs are a very good indicator of the state of patient health. - -Normal is warm, pink, and dry. Any difference? (eg hot, flushed, sweaty, pale, bluish,…) If there an immediate threat to life, you must find it, and address it now

3. Assess the ABCs – A1 = Airway - Can the patient maintain their airway without assistance? If not, assist B1 = Breathing - Look, Listen and Feel for 10 seconds; if none, at least rescue breathing C1 = Circulation - Check radial or carotid pulse for 10 seconds, if none, CPR If A1B1C1 issue, radio call, give situation, request help, and get to work Look for signs of shock First Impressions/ LOC/ ABCs

4. But there is more…. A2 = Abdomen - Rigid? Guarding? B2 = Breathing (Chest) - S & S of respiratory distress? Expose neck and chest to address C2 = C-spine - palpate at least C-spine; DCAP-BTLS; extremity CMS If A2B2C2 issue, radio call, give situation, request help, and get to work Assuming no major ABC issues, ask Tell me what happened, Tell me what hurts. First Impressions/ LOC/ ABCs