Downloadable Instructor's Guides
Topic: Rapid Trauma Assessment/Assessing and Prioritizing Fractures
Level of Instruction: 3
Time Required: 2 Hours
- Drill Transparencies/Blackboard
- Overhead Projector
- Live Victims
- EMT-B Bridge Student Guide, Lesson 1
- Brady Emergency Care (9th ed.)
Motivation: Upon arrival on the scene, EMT-B's sometimes mistake dramatic fractures for life threatening injuries. The intent of this drill is to remind rescuers that extremity trauma rarely causes a life threatening situation. In cases where significant MOI exits, ABC's and Rapid Trauma Assessment is your first action.
Objective (SPO): The student will demonstrate a basic understanding of rapid trauma assessment, and prioritizing fractures.
Overview: Rapid trauma assessment, and assessing and fractures
- Rapid PA
- Prioritizing fractures
- Principles of treating fractures
Rapid Trauma Assessment/Assessing and Prioritizing Fractures
- SPO 1-1
Describe the indications for performing a rapid trauma assessment
Describe in order how to perform a rapid trauma assessment.
Describe how to prioritize fractures.
List the general principles for the management of suspected fractures or dislocations
- EMT-B's responding to incidents with a report of significant Mechanism of Injury, should be prepared to perform the following basic objectives:
- Scene Survey
- Simultaneous Actions (LOC, c-spine, jaw thrust)
- Assessment of the airway
- Assessment of breathing
- Possible support of ventilation/supplemental 02
- Assessment of circulation
- Control bleeding
- DCAP-BTLS patients entire body (Fx assessed and stabilized)
- Determine if patient is a critical trauma
- Load and go/ or treat patient at scene
- Baseline vitals
- SAMPLE HISTORY
- Detailed physical exam
- Ongoing assessment(en route to trauma center)
Rapid patient assessment
- SCENE SURVEY
- Body substance isolation
- Scene safety/ Hazards
- Determine MOI or NOI (mechanism of injury or nature of illness).
- How many victims?
- Are other resources needed?
- SIMULTANEOUS ACTIONS
- Determine LOC using the following scale:
- V=Responds to verbal stimulus
- P=Responds to painful stimulus
- Manually immobilize C-spine
- Jaw thrust to establish airway if necessary
- Assessment of AIRWAY
- Jaw thrust needed?
- Is airway open?
- Inspect for foreign bodies
- Need suctioning?
- Consider airway adjunct
- Assessment of BREATHING
- Is it present?
- Approximate rate
- Character of respirations
- Are respirations adequate?
- Supporting VENTILATIONS
- Give 15 lpm O2 via NRB if rate is greater than 8 and breathing is adequate
- Bag Valve Mask w/reservoir and 15 lpm O2 at 24 per minute if:
- Respiratory rate less than 8
- Breathing is inadequate
- Head trauma is suspected
- Assessment of CIRCULATION
- Carotid pulse
- Approximate rate?
- CONTROL BLEEDING
- ASSESS THE HEAD (quickly through) DCAP-BTLS for obvious injury (inspect and palpate)
- Assess the NECK (anterior and posterior) DCAP-BTLS
- Trachea: midline or deviated?
- Jugular veins distended or flat?
- Any signs of trauma?
- Medic Alert Tag?
- Apply a cervical spinal immobilization collar
- Assess the CHEST
- Expose, inspect and palpate the chest DCAP-BTLS
- Auscultate Chest Bilaterally
- Compare sounds from side to side
- Heart sounds
- Same rate as pulse?
- Expose, inspect and palpate abdomen DCAP–BTLS
- Firm or Soft
- Expose, inspect and palpate pelvis with gentle pressure downward and inward DO NOT ROCK! DCAP-BTLS
- Expose, inspect and palpate LOWER EXTREMITIES DCAP-BTLS
- Distal pulses
- Motor function
- Sensory function
- CRITICAL TRAUMA SITUATIONS appropriate to LOAD and GO.
- Stabilize patient on a spine board. Treat non-life threatening injuries en route. Do not waste time on the scene.
- ASSESS BASE LINE VITALS, but do not delay critical treatment or transport. They can be done en route.
- Blood pressure
- Skin color, temperature, moisture
- SAMPLE HISTORY
- Symptoms and signs
- Past illness
- Last Meal
- Events prior
- Detailed Physical Examination en route to trauma center (old secondary survey).
- Repeat and record findings of initial assessment every five minutes