AES218: Sizing up the Scene and SAMPLE/OPQRST

reviewing first steps when arriving at the scene

OPQRST

Onset: “when did this start?”

OPQRST

Provoke/Palliation: “what makes it worse? what makes it better?”

OPQRST

Quality: “what does the pain feel like?” (sharp, dull, crushing)

OPQRST

Region/Radiation: “Where does it hurt? is the pain spreading?”

OPQRST

Severity: "On a scale of 1 to 10, how bad is the pain?"

OPQRST

Time: “Is the pain/issue getting better or worse over time?”

SAMPLE

Signs/Symptoms: Observations or complaints that indicate a medical condition or injury. “what’s going on? can you tell me how/what you’re feeling?”

SAMPLE

Allergies: “are you allergic to anything?”

SAMPLE

Medications: “are you taking any medications? have you already taken them?”

SAMPLE

Pertinent Medical History: “has this happened to you before? did you have to go to the hospital? is there any other medical history I should know about?”

SAMPLE

Last oral intake: “what was the last thing you ate/drank? when? have you taken any medication already?”

SAMPLE

Events leading up to incident: “what happened? what were you doing when this started?”

AVPU

Alert - responsive, AOx4

AVPU

Verbal - responds to voice

AVPU

Pain - responds to painful stimulus (tapping hard, pinching, sternum rub)

AVPU

Unresponsive - patient does not respond to any stimulus.

AOx4: Person

“Who are you, what’s your name, how old are you?”

AOx4: Place

“do you know where you are?”

AOx4: Time

“what time is it, what day is it, what year is it?”

AOx4: Events

“what happened, what’s going on?”

Consent/Introduction

“Hi, my name is (full name), I’m a registered EMR, can I help you/your child?”

What do you say to 911? (when responding to a scene)

1) name/training/location — “my name is ____, I’m a registered EMR, I’m at emergency beach”

2) What happened? — “someone collapsed”

3) condition of the patient — “they are struggling to breath, they are flushed, etc”

4) number of victims — “only one person”

5) scene safety — “the scene is safe but we are near the water”

6) MOI/NOI (cause) — “they’re having an exercise induced asthma attack”

7) request equipment — “we need a BVM and an AED”

What do you do while waiting for the ambulance?

EITHER - continue to provide care OR conduct secondary assessment.

DOTS

Deformities

DOTS

Open injuries

DOTS

Tenderness

DOTS

Swelling

Sizing up the scene

1) Safety
2) Number of victims

3) MOI/NOI

4) what happened

5) condition of victims

When to call 911

1) Severe respiratory

2) severe cardiac

3) Head, neck, back, abdomen, chest

4) severe MOI/NOI

5) ALOC (altered level of consciousness)

Four unusuals

Sight, sound, smells, behavior