EMT Trauma Assessment

BSI

PENMAN

General Impression
Is the patient tracking me?
How is work of breathing?
Skins?
C-spine?

0 x 4 Introduction
Approach patient on their right side.
Don’t move.
Hand extended.
My name is Frank, we are EMTs.
Can we help you?
I am going to stabilize your neck if there was any injury.
What's your name?
Why did we get called here today? Or Why did you call us today?
These questions may sound silly.
Do you know where we are?
Do you know what time it is?
Delegating inline stabilization to Casper.
Out of line palpating back of neck for DCAPBLSTIC.
Do I see blood?

Big Picture
Airway- Is the airway open and maintainable?
Is there need for an adjunct or suctioning?
Oxygen 15 lpm non-rebreather mask.
OPA, NPA, BVM,
Breathing- Rate and effort?
Circulation- Any major bleeding?
Checking pulse for rate rhythm and quality at the Radial and Carotid Pulse. Check
cap refill. Simultaneously feel skin for color, temperature, and moisture.

Intervention- Load and go or stay and play.

Baseline vitals-
Pulse- Rate rhythm and quality. Are they equal?
Weak, rapid, or thready. Weak, normal, strong, or bounding.
Regular or irregular.
Respiration- Rate and effort. Tidal volume. Shallow, normal, or labored.
 B/P-
Eyes- PEARL? Symmetry, size, conjugate gaze. Sluggish, unresponsive.
Lungs- RRQ clear bilaterally?
Skins- CMT. Cap refill, (immediate/delayed?)

SAMPLE/OPQRST/Cut Clothes
o Signs and symptoms
o Where did this happen?
o How did this happen?
o Can you describe the pain for me?
o Where do you hurt?
o Does the pain go anywhere?
o On a scale of 1-10 how bad do you hurt?
o When did this happen?
o Do you have any allergies?
o Do you take any medications?
 What do you take?
 For what?
o What is the last thing you ate and drank?
o What were you doing prior to this?

Nose to Knee Assessment

Visualizing head for DCAPBLSTIC
Paying close attention to eyes, eye sockets, nose, ears, mouth, mandible
Palpating back of neck for DCAPBLSTIC (if not done during inline
stabilization
Visualizing neck for
Jugular Vein Distention, Trachea Deviation, Stoma, Medical Tag, Rice
Krispy
C-collar

Chest
Visualizing Chest for DCAPBLSTIC.
Palpating chest for DCAPBLSTIC.
Place hand in karate position over patients sternum. Does this hurt?
Apply pressure. Does this hurt?
Hands to lateral sides of chest. does this hurt?
Lung sounds- start with patients left side while holding hand on patients right.
What do I hear? Clear bilaterally?

Abdomen- visualizing abdomen for DCAPBLSTIC. What do I see?

Do you have any pain in your abdomen? If patient has pain in abdomen,
palpate painful spot last.
Feeling for Rigidity, Distention, and Masses.
Use two hand technique and roll hand over four quadrants.
 Pelvis- visualizing pelvic region for DCAPBLSTIC.
Place hands at iliac crest. Does this hurt? Apply light pressure down. Does
this Hurt?
Move hands down to side and apply pressure down and in? hurt?
Femur- Visualizing Left and Right femurs for DCAPBLSTIC.
Place hand on upper femur, place other hand above knee inside.
Palpating right femur for midshaft femur fracture with offset pressure.
Palpating left femur for midshaft femur fracture with offset pressure.
Feet- CPMS visualizing feet for DCAPBLSTIC.
Checking dorsalis pedis pulse on top of feet (locate and mark)
Wiggle your toes.
What toe am I squeezing?
Cap refill. Immediate or delayed?
Hands- CPMS
Checking radial pulses.
Squeeze my thumbs, let go.
Squeeze my thumbs, let go.
What finger am I grabbing?
Cap refill. Immediate or delayed?

Back board patient