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Ensuring your personal protection begins by looking for what possible dangers as you approach the scene and before you step out of the vehicle?
- Oncomming traffic
- Unstable Surfaces
- leaking fluids and fumes
- Broken utility poles and downed electrical wires
- Aggravated or hostile bystanders with potential violence
- Smoke or Fire
- Possible hazardous or toxic materials
- Crash or rescue scenes with unstable elements
- Violence and crime scenes
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Define Mechanism of injury
With a traumatic injury, the body has been exposed to some force or energy that has resulted in a temporary injury, permanent damage, or even death.
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Blunt trauma
with blunt trauma, the force of the injury occurs over a broad area, and the skin is usually not broken
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Penetrating trauma
with penetrating trauma, the force of the injury occurs at a small point of contact between the skin and the object. The object pierces the skin and creates an open wound that carries a high potential for infection.
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What are examples of high priorty patients that should be transported immediatly?
- Difficulty breathing
- Poor general impression
- Unresponsive with no gag or cough reflexes
- Severe chest pain, especially when the systolic blood pressure is less than 100mm Hg
- Pale skin, or other signs of poor perfusion
- Complicated childbirth
- Uncontrolled bleeding
- Responsive But unable to follow commands
- Severe pain in any area of the body
- Inability to move any part of the body
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What are Significant MOI's?
- Ejection from a vehicle
- Death of another occupant of the vehicle
- Any fall equal to or greater than the patients hight, especially if the head strikes a firm surface first, or simultaneosly with the torso.
- Vehicle rollover
- High-speed vehicle collision
- Vehicle-pedestrian collision
- Motorcycle or bicycle crash
- Unresponsive or altered mental status following trauma
- Penetrating trauma to the head, chest or abdomen.
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What questions should you ask and answer during the Ongoing assessment.
- Is treatment improving the patients condition?
- Has an already identified problem got better or worse?
- What is the Nature of any newly identified problems?
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What steps of the ongoing assessment?
- 1. Repeat the initial assessment
- 2. Reassess and record vital signs
- 3. Repeat your focused assessment regarding pt's C/O
- 4. Check interventions
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What are the steps for the Initial assessment?
- Approach and form a general impression
- Assess Mental status
- Assess the airway
- Assess breathing
- Assess circulation
- Identify Priority pt's and make transport dicisions
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An ariway Obstruction in an unconscious pt is most commonly due to relaxation of the tongue muscles, allowing the tongue to fall to the back of the throat. What are signs of airway obstructions?
- Obvious trauma, blood or other obstructions
- Noisy breathing, such as snoring, bubbling, gurgling, crowing, or other abnormal sounds
- Extremely shallow or absent breathing
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When assessing the pt's breathing you should ask yourself what questions?
- Does the pt appear to be choking?
- Is the respiratory rate too fast or to slow?
- Are the pt's respirations shallow or deep?
- Is the pt cyanotic?
- Do you hear abnormal sounds when listening to the lungs?
- Is the pt moving air into and out of the lungs on both sides?
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Crepitus
A grating or grinding sensation caused by fratured bone ends or joints rubbing together; also air bubbles under the skin that produce a crackling sound or crinkly feeling.
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Hypothermia
A condition in which the internal body temperature falls below 95F (35C) after exposure to a cold envirnment.
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Paradoxical motion
The motion of the chest wall section that is detatched in a flail chest; the motion is exactly the opposite of normal motion during breathing.
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Rales
Crackling, rattling, breath sound that signals fluid in the air spaces of the lungs; also called crackles
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Rhonchi
Coarse, low-ptched breath sounds heard in pt's with chronic mucus in the upper airways.
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