8/12/2019 CH03 Assess

1/24

Chapter 3

Victim Assessment and Urgent Care

8/12/2019 CH03 Assess

2/24

Lesson Objectives

Explain the importance of performing a detailed and

systematic assessment.

List what to look for during the scene survey.

Identify and describe the steps of the initial assessment.

Use the SAMPLE mnemonic to obtain a victims history.

Assess a victims vital signs and perform a physical exam. Know how to perform ongoing assessment of a victim.

Know how to handle multiple-victim incidents (ie, triage).

8/12/2019 CH03 Assess

3/24

Assessment (1 of 2)

Perform a rapid, accurate assessment.

Skills must be learned well and practicedregularly.

8/12/2019 CH03 Assess

4/24

Assessment (2 of 2)

Five-part victim assessment:

Scene survey Initial assessment

Victims history

Vital signs and physical exam

Ongoing assessment

8/12/2019 CH03 Assess

5/24

Scene Survey (1 of 2)

Provides first impression and reveals hazards

Protect yourself from blood or bodily fluids.

8/12/2019 CH03 Assess

6/24

Scene Survey (2 of 2)

What to look for

What is cause of condition and relatedproblems?

Is the scene safe?

Is the victim injured or ill?

What is the mechanism of injury? Is the victim responsive or unresponsive?

How many victims are there?

8/12/2019 CH03 Assess

7/24

Initial Assessment (1 of 4)

Initial assessment is designed to detect

life-threatening conditions.

Determine if the victim is responsive or

unresponsive.

If unresponsive, prepare to evacuate.

Assess breathing problems and bleeding;attend to these problems before

proceeding further.

8/12/2019 CH03 Assess

8/24

Initial Assessment (2 of 4)

Assess the airway

If responsive personcannot speak or

cough, treat for

obstructed airway.

What to do: Open

airway using head tilt

chin lift maneuver.

8/12/2019 CH03 Assess

9/24

Initial Assessment (3 of 4)

Assess breathing

Determine whether victim is breathing normallyand adequately.

Look, listen, and feel for movement of air.

What to do:

Recovery position Rescue breathing

8/12/2019 CH03 Assess

10/24

Initial Assessment (4 of 4)

Check for hemorrhage

Severe bleeding,

external or internal, can

be life threatening.

Check entire body for

blood.

Expose affected area. Apply direct pressure.

8/12/2019 CH03 Assess

11/24

Victims History (1 of 2)

Use SAMPLE mnemonic to remember

steps in obtaining history. If victim cannot provide history, obtain it

from companions.

Check for a medical identification tag.

8/12/2019 CH03 Assess

12/24

Victims History (2 of 2)

SAMPLE mnemonic

Symptoms

Allergies

Medications

Past relevant medical

history

Last oral intake

Events leading up to

the injury or illness

Courtesy of the MedicAlert Foundation. 2006, All RightsReserved. MedicAlertis a federally registered trademark andservice mark.

8/12/2019 CH03 Assess

13/24

Vital Signs and Physical Exam(1 of 9)

Assess level of responsiveness, pulse, breathing,

body temperature, skin condition.

Check vital signs at the start of physical exam.

Assess vital signs frequently for unstable victims.

8/12/2019 CH03 Assess

14/24

Vital Signs and Physical Exam(2 of 9)

Level of responsiveness: AVPU scale

A = AlertV = Responds to verbal stimuli

P = Responds to painful stimuli

U = Unresponsive to voice or pain

8/12/2019 CH03 Assess

15/24

Vital Signs and Physical Exam(3 of 9)

Pulse

Radial pulse Practice until you

can find pulse

easily and quickly.

8/12/2019 CH03 Assess

16/24

Vital Signs and Physical Exam(4 of 9)

Breathing

Snoring Stridor

Wheezing

Gurgling

Rattling

8/12/2019 CH03 Assess

17/24

Vital Signs and Physical Exam(5 of 9)

Temperature

Can alert you to fever, heat illness, orhypothermia.

Carry a thermometer in your first aid kit.

Estimate body temperature by placing the back

of your hand on the victims forehead.

8/12/2019 CH03 Assess

18/24

Vital Signs and Physical Exam(6 of 9)

Skin condition

Color and temperature Moisture

8/12/2019 CH03 Assess

19/24

Vital Signs and Physical Exam(7 of 9)

Physical examination

Perform a thorough, systematic physicalassessment.

Victims with minor injuries or illnesses might

not require a complete physical assessment.

8/12/2019 CH03 Assess

20/24

Vital Signs and Physical Exam(8 of 9)

Physical examination

DOTS mnemonic:D = Deformities

O = Open wounds

T = Tenderness

S = Swelling

8/12/2019 CH03 Assess

21/24

Vital Signs and Physical Exam(9 of 9)

Physical examination

After the physical exam You should have a good idea of what is

wrong with the victim.

Suspect a spinal injury in any unresponsive

person injured in a high-velocity episode.

8/12/2019 CH03 Assess

22/24

Ongoing Assessment

Used to monitor victims condition.

Determine whether victims condition isstaying the same.

Reassess: Breathing, mental status, vital signs

Every 5 minutes for unstable victims Every 15 minutes for stable victims

Monitor results of first aid care.

8/12/2019 CH03 Assess

23/24

Multiple-Victim Incidents (Triage)(1 of 2)

Emergency situations with two or more victims

Decide who to care for and evacuate first.

Tell mobile victims to move to specific area.

These victims are in lowest-priority category.

Find highest priority victims by performing

assessment on remaining victims. Go to

motionless victims first.

Spend fewer than 60 seconds with each victim.

8/12/2019 CH03 Assess

24/24

Multiple-Victim Incidents (Triage)(2 of 2)

Triage categories:

Highest priority Second priority

Lowest priority