Chapter 4

Finding Out What’s Wrong

Checking the Victim• Victim assessment• Sequence of actions that helps determine

what is wrong • Ensures safe and appropriate first aid• Goals are:

• Detect life-threatening conditions rapidly• Determine other problems needing care• Determine if the victim needs medical

care

Scene Size-Up

• Determines the safety of the scene

• Cause of injury or nature of illness

• Number of victims

• If scene appears hazardous, do not enter!

Initial Check (1 of 5)

• Determines if there are life-threatening problems requiring quick care.

• Involves checking the victim’s responsiveness, opening the airway, checking for breathing, and checking for severe bleeding.

Initial Check (2 of 5)

• Determine if the victim is responsive.

Initial Check (3 of 5)

• Ensure that the victim’s airway is open.

Initial Check (4 of 5)

• Determine if the victim is breathing.

Initial Check (5 of 5)

• Check for any obvious, severe bleeding.

General Impression of Victim

• Also known as first impression, look test, or a gut reaction

• Determine whether the victim is injured or ill.

Check Responsiveness

• Victim can be responsive or unresponsive

• AVPU scale

• A – alert

• V – Responsive to verbal stimulus

• P – Responsive only to painful stimulus

• U – Unresponsive to any stimulus

Open Airway

• Airway must be open for breathing.

• Use the head tilt-chin lift method to open the airway.

Check for Breathing

• Check for breathing sounds that might indicate a problem.

• Check for breathing in an unresponsive victim while opening the airway.

• Look, listen, and feel.

Check for Severe Bleeding

• Look over the victim’s entire body for blood.

• Apply direct pressure and a sterile dressing.

• Avoid contact with the victim’s blood.

Skin Condition

• Skin temperature

• Color

• Reflects circulation

• Condition

Expose the Injury

• Clothing may have to be removed to check for injury and to provide first aid.

• Explain what you intend to do and why first.

Physical Exam

• Goal is to immediately identify any potentially life-threatening illness or injury.

• Most victims will not require a complete head-to-toe type of physical exam.

Signs and Symptoms• Signs

• Victim’s conditions you can see, feel, hear, or smell.

• Symptoms

• Things the victim feels and is able to describe; known as the chief complaint.

DOTS

• D = Deformity

• O = Open wounds

• T = Tenderness

• S= Swelling

Conducting a Physical Exam (1 of 7)

• Head: check for DOTS

Conducting a Physical Exam (2 of 7)

• Neck: check for DOTS

Conducting a Physical Exam (3 of 7)

• Chest: check for DOTS

Conducting a Physical Exam (4 of 7)

• Abdomen: check for DOTS

Conducting a Physical Exam (5 of 7)

• Pelvis: check for DOTS

Conducting a Physical Exam (6 of 7)

• Extremities: check both arms and legs for DOTS

Conducting a Physical Exam (7 of 7)

• Back: if no spinal injury is suspected, turn the victim on his or her side and check for DOTS

SAMPLE History

• S = Symptoms

• A = Allergies

• M = Medications

• P = Past medical history

• L = Last oral intake

• E = Events leading up to the illness or injury

Medical Identification Tags

• Look for a medical identification tag or a medical information card.

• Beneficial in identifying allergies, medications, or medical history

Putting It All Together• If victim requires medical care, pass this

information on:• Victim’s chief complaint• Responsiveness• Initial check• Physical exam findings• SAMPLE history• Any first aid that has been provided

Triage

• Process of prioritizing multiple victims

• Immediate care

• Urgent care

• Delayed care

• Dead

Advantages of the Left-Side Position

• Also called recovery position• Has several advantages:

• Keeps airway open• Delays vomiting• Delays poison’s effects• Relieves pressure on a

pregnant woman’s vena cava