View
74
Download
0
Category
Preview:
Citation preview
Chapter 4Finding Out What is Wrong
Assessment Overview
• Assessment: Sequence of actions that helps determine what is wrong
• A primary check will determine:− Illness or injury− Responsiveness or unresponsiveness− Existence of life-threatening condition
Assessment Overview
© Jones & Bartlett Learning.
Assessment Steps
• Perform a primary check.• Perform a physical exam.• Obtain the person’s SAMPLE history.
Scene Size-up
• Look for hazards.• Be aware of the potential for violence.• Be observant for weapons.• If scene appears hazardous, do not go in.• Reduce exposure.• Determine whether problem is injury or
illness.
Primary Check
• Identify life-threatening conditions so that you can immediately take action to treat the conditions.− Responsiveness− Circulation− Breathing− Severe bleeding
Primary Check
• Form a first impression.− Injury or illness?− Responsive or unresponsive?− Breathing adequately? Talking?− Bleeding?− Chance of exposure to blood or body fluids?− Danger to you, injured or ill person, or
bystanders?
Primary Check
• Check responsiveness.− Tap the person on the shoulder and ask, “Are
you okay?”• If the person does not respond, call 9-1-1.• If you cannot detect breathing, begin CPR.
Primary Check
• Check for breathing.− Chest movement− Normal and abnormal breath sounds− Cyanosis and skin color
© Jones & Bartlett Learning.
Primary Check
• Check for severe bleeding.− Check for a large amount of blood.
• Around the person• On the person’s clothing
− Control bleeding.− Wear exam gloves.
Primary Check
• Position the person.− Most people should not be moved.− Exceptions:
• Unsafe location• Person is face down and needs CPR• Person has difficulty breathing from vomit• First aid provider must leave to get help• Signs of shock develop
Placing an Unresponsive Breathing Person in the Recovery Position
• Kneel next to the person’s side.
• Straighten both legs.
• Place the arm nearest you out from the body.
© Jones & Bartlett Learning.
Placing an Unresponsive Breathing Person in the Recovery Position
• Bring the other arm across the person’s chest.
• Grab and raise the far knee until it is bent.
© Jones & Bartlett Learning.
© Jones & Bartlett Learning.
Placing an Unresponsive Breathing Person in the Recovery Position
• Grab the person’s bent knee and shoulder and roll the person toward you, onto the side.
© Jones & Bartlett Learning.
Placing an Unresponsive Breathing Person in the Recovery Position
• Adjust the top leg so that both the knee and the hip are bent at right angles.
• Keep the top hand under the person’s cheek.
© Jones & Bartlett Learning.
© Jones & Bartlett Learning.
Physical Exam
• Determine whether the cause of injury was significant.− Assume a person with a head injury also has
a spinal injury.
Physical Exam
• For a responsive person− Ask if he or she can feel or wiggle the fingers
and toes.• For an unresponsive person
− If you suspect a spinal injury, do not move the person’s head or neck.
Physical Exam
• Assess the person’s entire body.− Signs—conditions you can see, feel, hear,
and smell− Symptoms—things the person feels and is
able to describe• The chief complaint
Physical Exam
• D = Deformity• O = Open wounds• T = Tenderness• S = Swelling
© American Academy of Orthopaedic Surgeons.
© Jones & Bartlett Learning. Courtesy of MIEMSS.
© Johnathan Noden-Wilkinson/ShutterStock.
© American Academy of Orthopaedic Surgeons.
Significant Cause of Injury
• Check the head.• Check the eyes.• Check the ears
and nose.• Check the mouth.
© Jones & Bartlett Learning. Courtesy of MIEMSS.
Significant Cause of Injury
• Check the neck.• Check the chest.
− Gently press inward.
© Jones & Bartlett Learning. Courtesy of MIEMSS. © Jones & Bartlett Learning. Courtesy of MIEMSS.
Significant Cause of Injury
• Check the abdomen.− Gently press on all four quadrants.
© Jones & Bartlett Learning. Courtesy of MIEMSS.
Significant Cause of Injury
• Check the pelvis.− Gently press inward on tops of hips.− Press downward.
© Jones & Bartlett Learning. Courtesy of MIEMSS.© Jones & Bartlett Learning. Courtesy of MIEMSS.
Significant Cause of Injury
• Check all four extremities.− Circulation− Sensation− Movement
• Check the back.© Jones & Bartlett Learning. Courtesy of MIEMSS.
Special Considerations
• Skin condition− Temperature− Color− Moisture
© Jones & Bartlett Learning.
© Jones & Bartlett Learning.
Special Considerations
• Capillary refill test− Press fingernail or toenail for a few seconds
and release.
© American Academy of Orthopaedic Surgeons. © American Academy of Orthopaedic Surgeons.
Special Considerations
• Expose injury.− Explain what you
are doing.− Maintain privacy.− Prevent exposure
to cold.© American Academy of Orthopaedic Surgeons.
Special Considerations
• Check for medical identification tags.− Wallet− Purse− Necklace to cold.− Bracelet
Courtesy of the MedicAlert Foundation®. © 2006, All Rights Reserved. MedicAlert® is a federally registered
trademark and service mark.
Courtesy of the MedicAlert Foundation®. © 2006, All Rights Reserved. MedicAlert® is a federally registered trademark and service mark.
SAMPLE History
• Helps identify what is wrong with the person
• Can indicate what first aid is needed
© Jones & Bartlett Learning.
What to Do Until Medical Help is Available
• Recheck a serious illness or injury regularly.
• Remaining calm and reassuring the person may be the best treatment you can provide.
Recommended