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EtOH Toxicity September 15, 2014. Primary Assessment. Form a general impression. Do they need C-Spine? AVPU A&O assessment What’s your name (from ID)? Who is the president of the United States? What state (location) are you in right now? What is the year? Determine any life threats.

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etoh toxicity september 15 2014
EtOH Toxicity

September 15, 2014

primary assessment
Primary Assessment
  • Form a general impression.
    • Do they need C-Spine?
    • AVPU
    • A&O assessment
      • What’s your name (from ID)?
      • Who is the president of the United States?
      • What state (location) are you in right now?
      • What is the year?
    • Determine any life threats.
    • Do not be tricked! Conscious and breathing patient does not necessarily mean a stablepatient
primary assessment1
Primary Assessment
  • Airway and breathing
    • Are they talking to you? If so they have open airway – but be prepared for suction
    • Do not hesitate to give oxygen!
  • Circulation
    • Assess the patient’s circulatory status and pulse and skin condition
      • Cap refill!
primary assessment2
Primary Assessment
  • Transport decision
    • Based on:
      • Vitals (Are they stable?)
      • LOC
      • Trauma (Any obvious deformities i.e. evisceration at a tailgate two years ago)
      • Recommendation from fire safety
history taking
History Taking
  • Investigate the chief complaint.
    • If your patient is responsive, at this point begin to take a SAMPLE history.
    • If your patient is not responsive, obtain this history from bystanders (i.e. friends, family, ID, medical bracelets!)
      • If unresponsive use ALS, and gather as much information as possible for them (with at least one set of vitals)
history taking1
History Taking
  • SAMPLE history
    • Use SAMPLE as a tool of deductive reasoning to determine underlying conditions
  • Also, ask the following questions:
    • What is the substance involved (may not just be alcohol)?
    • How long ago did the patient use this substance?
    • How much of the substance did the patient consume?
  • Consider how much patient weighs when taking into consideration substance abuse
    • A 200 lb frat bro who is only responsive to pain only after 2 beers has something else going on with him
secondary assessment
Secondary Assessment
  • Physical examinations
    • Look for DCAPBTLS
  • Vital signs
    • Look for alterations in the LOC, HR, R, BP, and skin signs.
reassessment
Reassessment
  • Reassess ABCs.
  • Repeat the assessment of vital signs:
    • Every 15 minutes for a stable patient
    • Every 5 minutes for unstable patient
  • Average LAFD response time is 6 minutes. You should have at least one set of vitals and a SAMPLE done by the time they get there (unless unresponsive)!
possible underlying conditions
Possible Underlying Conditions
  • Trauma
  • Shock
  • Electrolyte disturbances
  • Cardiac disorders
  • Alcoholic Ketoacidosis
general tips
General Tips
  • Control the scene
    • Be confident (use the cheat sheet!) and don’t let the patient/patient’s friends bully you
    • You are here because they need help, and as a result you need to get certain information/vitals from them
    • Be friendly, yet stern