week 2

high priority → UDU-ASP-CS

unconscious

difficulty breathing

uncontrolled bleeding

altered LOC (A&O less than 2)

severe chest pain

pale skin/poor perfusion

complicated childbirth

severe pain in body

scene size up

BSI

PENMAN

primary assessment

AAA/GMC

xABC

Head to Toe (DCAP-BTLS) - 90 secs

history taking

OPQRST

SAMPLE

DCAP BTLS

deformity

contusions (bruising)

abrasions (scrapes/rubbing)

punctures

burns

tenderness

lacerations

swelling

secondary assessment

IPA

Head to Toe

PEARRL

PMSC

vitals

IPA

inspection

palpation

auscultation

rapid head to toe (7)

1. check head (pupils)

2. check neck (JVD, trachea movement, spinal step off)

3. check chest (equal chest rise/fall, crepitus, breath sounds, subcutaneous emphysema)

4. check abs (rigidity, distention)

5. check pelvis (compress down and in. tender? unstable?)

6. check extremities (bilateral, pulse, motor sensory)

7. check back/butt

secondary head to toe

1. obs head

2. obs eyes

3. look for redness and contacts. check pupil function

4. look behind ears

5. check ears for drainage

6. palpate skull

7. palpate zygomas

8. palpate maxillae

9. check nose for drainage

10. palpate mandible

11. assess mouth/nose

12. check breath odor

13. look for JVD

14. palpate front and back of neck

15. look at breathing in chest

16. palpate ribs

17. listen to anterior breathing

18. listen to posterior breathing

19. palpate abs and pelvis

20. compress pelvis from sides

21. press iliac crests

22. look at extremities (distal circulation and motor sensory)

23. inspect back for tenderness and deformities

snoring

upper airway obstruction

stridor

obstruction in neck/chest

wheezing

lower airway obstruction

crackles

fluid in lungs

rhonchi

mucus/fluid in lung

cough

low pitch in exhalation

PEARRL

pupils

equal

and

round

regular in size

reactive to light

assess neurovascular status (PMSC)

1. palpate radial

2. palpate posterior tibial and dorsalis pedis

3. assess cap refill

4. assess sensation on tip of fingers

5. assess sensation on tip of toes

6. assess sensation on side of foot

7. ask patient to move hand (open and close)

8. ask patient to move foot (point and flex)

pump failure causes

heart attack

trauma to heart

obstructive causes

low fluid volume causes

trauma to vessels/tissues

fluid loss from GI tract (vomit/vomit)

poor vessel function causes

infection

drug overdose

spinal cord injury

anaphylaxis

pump failure shock

cardiogenic shock

obstructive shock (pulmonary embolus/tension pneumothorax, cardiac tamponade)

poor vessel function shock

distributive shock (septic shock, neurogenic shock, anaphylactic shock, psychogenic shock)

low fluid volume shock

hypovolemic shock (hemorrhagic shock, nonhemorrhagic shock)

OPA

unconscious w/o gag reflex

apneic w/ bag mask device

DO NOT USE:

conscious

gag reflex

NPA

semiconscious/unconscious w/ gag reflex

wont have OPA

cant maintain own airway spontaneously

DO NOT USE:

facial trauma (blood in nose)

history of fractured nasal bone