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Taking Action In An Emergency: Initial Assessment. You have just arrived at the site of an emergency. What should you do first?. Step 1: Survey The Scene (check the scene). Piece together the puzzle Look for dangerous hazards Quickly determine: The number of victims The cause of injury

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Taking Action In An Emergency: Initial Assessment

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Presentation Transcript
step 1 survey the scene check the scene
Step 1: Survey The Scene(check the scene)
  • Piece together the puzzle
  • Look for dangerous hazards
  • Quickly determine:
    • The number of victims
    • The cause of injury
    • Are there witnesses?
survey the scene 2
Survey The Scene #2
  • Do not approach the victim if threatexists
survey the scene 3
Survey The Scene #3
  • Attain consent
    • Gain victim’s confidence
    • Identify problems
    • Don’t assume that the injury you see is the only one
    • Gather info that will be helpful to EMS
survey the scene 4
Survey The Scene #4
  • Remain calm
  • Call EMS if needed
  • Do not move the victim unless it is necessary to support life or life threat exists
step 2 the initial victim assessment
Step 2: The Initial Victim Assessment
  • Identify and correct life threatening conditions related to
    • Airway
    • Breathing
    • Circulation
    • Disablity
goal of the initial assessment
Goal of the Initial Assessment
  • To assess heart, lung, brain and spinal cord functioning (address life support – does the victim need CPR?)
    • Cardio Pulmonary Resuscitation
      • Cardio refers to heart
      • Pulmonary refers to lungs
      • Resuscitate refers to revival
how to proceed through the initial assessment rapabcd
How To Proceed Through The Initial Assessment:RAPABCD
  • R - check for responsiveness
    • A – alert
    • V – responds to voice
    • P – responds to pain
    • U – unconscious, no responses
  • A - activate EMS (911)
  • P - position victim on the back
how to proceed 2 rap abcd checking for vital signs pulse and respiration
How To Proceed #2: RAP ABCD(checking for vital signs - pulse and respiration)
  • A - Airway
  • B - Breathing
  • C - Circulation
  • D – disability
  • Open the airway by “head tilt, chin lift”
  • If spinal cord injury is suspected, be more cautious
  • Look, listen, and feel for breathing (no more than 10 seconds)
  • Check for major bleeding
    • No longer required to check for pulse
secondary assessment history and physical exam
Secondary Assessment: History and Physical Exam
  • Head to toe for major injury or unresponsive
    • Minor injury, examine complaint only
    • More regarding head to toe exam will follow
the secondary assessment
The Secondary Assessment
  • Identify yourself
  • Obtain consent
  • Ask and use the victim’s name
  • Ask about chief complaint
  • Use SAMPLE to help you remember questions to ask the victim
questions to ask sample
Questions To Ask: SAMPLE
  • S - symptoms
    • symptom: something the victim tells the first aider
    • sign: something the first aider sees, hears, or feels
  • A - Allergies
sample 2
Sample #2
  • M - Medication
  • P - Pre-existing illnesses
  • L - Last food (food poisoning? hypoglycemia?)
  • E - Events prior to the injury
the secondary assessment18
The Secondary Assessment
  • Systematically look and feel (LAF)
  • Look for: DOTS
    • D - deformity
    • O - open wounds
    • T - tenderness
    • S - swelling
  • Start with the head for adults, feet for children
check the head
Check The Head
  • DOTS
  • Feel both sides of the head
  • CSF fluid (clear fluid from ear or nose / halo effect)
check eyes pearl
Check Eyes: PEARL
  • Are pupils equal and react to light?
  • Use flashlight or cover one eye with a hand
  • Pupils normally contract in one second
  • No pupil reaction could mean death, coma, cataracts, artificial eye
check eyes 2
Check Eyes #2
  • Pupil dilation occurs within 30-60 seconds of a cardiac arrest
  • Look for unequal pupils (stroke, head or brain injury)
  • Check inner eye lid: it should be pink
check neck and chest
Check Neck and Chest
  • Check for cuts, bruises, compare sides
  • Apply slight pressure to sides of chest (checking for broken ribs)
  • Ask if pain is present
  • If pain is present, gently press on opposite side of pain site to help determine area affected
  • Feel for lumps
  • Feel the 4 abdominal quadrants
  • Gently press downward and squeeze inward
extremity assessment
Extremity Assessment
  • Check arms and legs
    • deformity
    • tenderness
    • Check for :
      • C - Circulation (pulse sites)
      • S - Sensation
      • M - Movement
extremity assessment 2
Extremity Assessment #2
  • Compare extremities
    • Check temperature of the extremity
  • Check nail bed
    • instant refilling means good circulation
    • normal refill time is < 2 seconds
spine and back
Spine and Back
  • Ask victim about movement in extremities
  • Wiggle fingers, toes
  • Have victim press foot against your hand
  • Have victim squeeze your hand
  • Babinski reflex test
    • Injured? Big toe flexes upward
check for a medical alert tag
Check for a Medical Alert Tag
  • 24 hour emergency phone number
  • Do not remove tag unless absolutely necessary
reassess abc s
Reassess ABC’s:
  • Every 5 minutes if unconscious or serious injury
  • Otherwise, every 15 minutes if conscious
is there a head or spinal injury
Is There a Head or Spinal Injury?
  • Always stabilize the head immediately
  • Signs of Spinal Cord Injuries
    • Painful movement of arms and legs
    • Numbness, tingling, weakness, burning, lessened sensation in arms or legs
    • Loss of bowel or bladder control
    • Paralysis of arms or legs
    • Deformity
post emergency numbers near the telephone
Post Emergency Numbers Near The Telephone
  • Fire department
  • Police
  • Ambulance or EMS (paramedics)
  • Physician
  • Poison Control Center
calling emergency medical services ems 911
Calling Emergency Medical Services (EMS - 911)
  • A two minute delay in calling EMS can be deadly
  • If in doubt, call EMS
  • Questions by dispatchers are not to question the need of the call but to determine the level of need
what to tell 911 dispatcher
What To Tell 911 Dispatcher
  • First, speak slowly and clearly
  • When calling from a cell phone, give the address immediately
  • Listen carefully to the dispatcher
tell the dispatcher
Tell The Dispatcher :
  • Location
  • Telephone number
  • What has happened
  • Number of persons needing help
  • Special conditions
  • Your assessment of the victim
  • Do not hang up unless the dispatcher instructs you to