TRAUMA ASSESSMENTBASIC TRAUMA COURSE

The goal of the primary assessment is to rapidly identify potentially life-threatening condition requiring immediate intervention.

AIRWAY/CERVICAL SPINE

A- Airway-Open or patent-Cervical Spine immobilized Can they vocalize? Tongue obstructing airway Loose teeth, blood, or vomit in mouth Edema If patient already intubated when arrives: Equal rise and fall of the chest with ventilation Listening over epigastrium and then over the lung

fields Specific device to confirm tube placement

BREATHING Assess presence and effectiveness Spontaneous breathing Rise and fall of the chest Rate and pattern of breathing Use of accessory muscles, diaphragmatic

breathing or both Skin color Bilateral breath sounds Tracheal deviation and JVD

CIRCULATION Presence of major pulses, Presence of

external hemorrhage Palpate a central pulse (carotid,

femoral, or brachial in infants under one year of age)

Inspect and palpate skin Capillary refill time

DISABILITY Brief neurologic assessment to determine the degree of

disability. Level of consciousness-Determine level of consciousness using

the AVPU mnemonic A AlertV Verbal stimuliP Painful stimuliU Unresponsive

Glasgow Coma Scale-Variations for pediatrics Best Eye Opening Best Verbal Response Best Motor Response

Pupillary assessment-Size, shape, equality , and reaction to light

EXPOSE/ENVIRONMENT/EVIDENCE Get Naked! Decontaminate if needed. Cover up & keep warm. Consider if clothing may be evidence

and preserve it.

CONSIDER TRANSFER Consider the need for transfer for

following conditions: Significant head or spinal cord injury,

major chest wall trauma, open pelvic or solid organ injury, major crush injuries, traumatic amputation with potential for re-implantation, major burns, multiple long bone fractures, and Multi-system trauma.

SECONDARY ASSESSMENT F-Full set of Vitals, Focused adjuncts

(Labs, monitors, F/C, NG), Facilitate family presence

G-Give comfort-touch, talking, and pharmacologic pain management.

H-History-MIVT (MOI, Injuries, VS, TX), Past medical hx, Head to toe- Inspection, palpation, Percussion, Auscultation

I-Inspect Posterior, rectal tone, temp

FOCUSED ASSESSMENT Trauma documentation Wound care Tetanus prophyx Antibiotics Prepare for transfer

EVALUATION & MONITORING Continually monitor and treat: Airway patency Level of Consciousness Hemodynamic status Breath sounds and pulse oximetry Cardiac rate and rhythm Pain relief Intake and output