1. Assessments

2. Scene Size-Up Body Substance Isolation (BSI) Body Substance Isolation (BSI) Four Main Components Four Main Components 1. Scene Safety 2. Mechanism of Injury (MOI) - Trauma Nature of Illness (NOI) - Medical 3. Number of Victims 4. Resources Needed

3. Initial Assessment Initial Assessment Initial Assessment has five components: Initial Assessment has five components: Forming a general impression Forming a general impression Assessing the level of consciousness or mental status Assessing the level of consciousness or mental status Assessing the victim’s airway Assessing the victim’s airway Assessing the victim’s breathing Assessing the victim’s breathing Assessing the victim’s circulation Assessing the victim’s circulation Record and report the findings of the initial assessment Record and report the findings of the initial assessment

4. Physical Exam and SAMPLE History Physical Exam and SAMPLE History Physical exam Physical exam Purpose of the physical exam Purpose of the physical exam Medical complaints Medical complaints “Head-to-toe” exams “Head-to-toe” exams DOTS DOTS Inspect (look) and feel (palpate) Inspect (look) and feel (palpate)

5. SAMPLE History Interview victim and/or bystanders Interview victim and/or bystanders Medical identification tags Medical identification tags SAMPLE SAMPLE Signs and Symptoms Signs and Symptoms Allergies Allergies Medications Medications Pertinent past medical history Pertinent past medical history Last oral intake Last oral intake Events Events Do SAMPLE before physical exam on medical pts Do SAMPLE before physical exam on medical pts

6. Ongoing Assessment Ongoing Assessment Monitor Vital Signs Monitor Vital Signs LOC LOC Breathing and circulation Breathing and circulation Repeat initial assessment Repeat initial assessment Every 5 min for unstable pts Every 5 min for unstable pts Every 15 min for stable pts Every 15 min for stable pts Repeat Physical Exam if needed Repeat Physical Exam if needed Record all findings to turn over to advanced medical personnel Record all findings to turn over to advanced medical personnel

7. Skill Practice: Initial Assessments & Physical Exam with SAMPLE History Bring your skill sheets to the practice area Bring your skill sheets to the practice area Get in groups of 3 Get in groups of 3 Practice an initial assessment (conscious & unconscious) Practice an initial assessment (conscious & unconscious) Do at least one complete physical exam Do at least one complete physical exam Do at least one SAMPLE history Do at least one SAMPLE history

8. You arrive on the scene of an automobile crash involving one vehicle that has struck a guardrail head-on. The car is still running. The driver did not have on a safety belt and struck the steering column. He is seated behind the steering wheel, conscious and complaining of chest and abdominal pain. The other passenger also was not wearing a safety belt. She is lying motionless, facedown on the floor of the vehicle. You see blood around her body. She is unconscious and not breathing. You are unsure if she has a pulse. You arrive on the scene of an automobile crash involving one vehicle that has struck a guardrail head-on. The car is still running. The driver did not have on a safety belt and struck the steering column. He is seated behind the steering wheel, conscious and complaining of chest and abdominal pain. The other passenger also was not wearing a safety belt. She is lying motionless, facedown on the floor of the vehicle. You see blood around her body. She is unconscious and not breathing. You are unsure if she has a pulse. Use these steps to guide your answers. Use these steps to guide your answers. Scene size-up Scene size-up Initial assessment Initial assessment Call more advanced medical help (if needed) Call more advanced medical help (if needed) Physical exam Physical exam Use bystanders appropriately Use bystanders appropriately Break-out Session