PATIENT ASSESSMENT/MANAGEMENT - TRAUMA

This station is designed to test your ability to perform a patient assessment of a victim of multi-system trauma and voice-treat all conditions and injuries discovered. You must conduct your assessment as you would in the field, including communicating with your patient. You may remove the patient's clothing down to shorts or swimsuit if you feel it is necessary. As you conduct your assessment, you should state everything you are assessing. Clinical information not obtainable by visual or physical inspection, for example blood pressure, will be given to you after you demonstrate how you would normally gain that information. You may assume that you have two EMTs working with you and that they are correctly carrying out the verbal treatments you indicate. You have (10) ten minutes to complete this skill station. Do you have any questions?

Takes or verbalizes body substance isolation precautions

SCENE SIZE-UP
Determines the scene is safe
Determines the mechanism of injury
Determines the number of patients
Requests additional help if necessary

Considers stabilization of spine

INITIAL ASSESSMENT
Verbalizes general impression of patient
Determines responsiveness
Determines chief complaint/apparent life threats

Assesses airway and breathing
Assessment
Initiates appropriate oxygen therapy
Assures adequate ventilation
Injury management

Assesses Circulation
Assesses for and controls major bleeding
Assesses pulse
Assesses skin (color, temperature and condition)

Identifies priority patients/makes transport decision

FOCUSED HISTORY AND PHYSICAL EXAM/RAPID TRAUMA ASSESSMENT

Selects appropriate assessment (focused or rapid assessment)

Obtains or directs assistant to obtain baseline vital signs

Obtains SAMPLE history

DETAILED PHYSICAL EXAMINATION

Assesses the head
Inspects and palpates the scalp and ears
Assesses the eyes
Assesses the facial area including oral and nasal area

Assesses the neck
Inspects and palpates the neck
Assesses for JVD
Assesses for tracheal deviation

Assesses the chest
Inspects
Palpates
Auscultates the chest

Assesses the abdomen/pelvis
Assesses the abdomen
Assesses the pelvis
Verbalizes assessment of genitalia/perineum as needed

Assesses the extremities
includes inspection, palpation, and assessment of pulses, sensory and motor activities

Assesses the posterior
Assesses thorax
Assesses lumbar

Manages secondary injuries and wounds appropriately

Verbalizes reassessment of the vital signs

CRITICAL CRITERIA

Did not take or verbalize body substance isolation precautions
Did not assess for spinal protection
Did not provide for spinal protection when indicated
Did not provide high concentration of oxygen
Did not find or manage problems associated with airway, breathing, hemorrhage or shock (hypoperfusion)
Did not differentiate patient's needing transportation versus continued on scene assessment
Does other detailed physical examination before assessing airway, breathing and circulation
Did not transport patient within ten (10) minute: time limit