Scene: Safe? How many? How bad ? MoI for spine? EVAC Numbers: 800.508.1276, via AAC: 617.459.4200 (19745)

Method of Injury: ________________________________________________________________________________________

Secure head/neck Look/Ask/Feel Patient ABCDE

Stop + Fix

SUB Name: __________________ Age: _______ Sex: M/F Chief Complaint:___________________________________________

Airway: ______ Breathing: ______ Circulation/Blood Sweep: _______ Disability/decision (If no MoI): __________

Env/ Exposure: _________ , Tattoo /Med-A-Lert,

Head-to-Toe Exam revealed: _______________________________________________________

OBJ Vitals Time _________ __________ __________ ___________

Alert (Person/Place/Time/Event) /Verbal/Pain/Unresponsive

Level of R ___ +O__ __ +O__ __ +O__ __ +O__

HR ___ x4= ___ ___ x4= ___ ___ x4= ___ ___ x4= ___ Reg/Irr : Strong/Weak

RR ___ x2= ___ ___ x2= ___ ___ x2= ___ ___ x2= ___ Labored/Unlabored: Shallow/Deep

Skin Color Temp Moisture _________ __________ __________ ___________

Include signs in the objective information. Make sure to also include symptoms in your notes as well.

Sx: ___________________________________________________________________________________________________

Allergy: What: ____________________ Exposure? Y/N/Unk Reaction: _______________ Tx: ______________________

Medications: Name: __________________ For: ________________________ Last Time Taken: ____________________

Name: __________________ For: ________________________ Last Time Taken: _____________________

Name: __________________ For: ________________________ Last Time Taken: ____________________

Include dosage questions in the medications section: what, when, why, how much, did you have it today

Hx: has this happened before, do you see a doctor on a regular basis for anything

__________________________________________________________________________________________________

Food/ H2O: Last In/Out: ________________ What: ____________________ Output Color/Consistency: _____________

PG? Y/N/Unk

Events: Recent Illness/Injury: events of the last 48 to 72 hours __________________________________________________

Focused Spine Assess: A+ O 3 /4 N/Y→Sober? N/Y→Free from distraction (pinch): N/Y→CirculationSensationMovement

N/Y(in all 4 extremities)→Free of Spine Pain on palpation? Y/N (if yes to all then OK to move or release head)

ASSESS: Based on MoI, Possible _______________________________ Possible ____________________________________

Possible _______________________________ Possible ____________________________________

PLAN, Tx: _______________________________________________________________________________________________

_______________________________________________________________________________________________

EVAC PLAN: ____________________________________________________________________________________________

ANTICIPATED PROBLEMS ______________________________________________________________________________

Tx Tips:

Mild head injury: Amnesia A=O2,3,4→Nausia→Headache→Dizzy→Tired→Vomit OK to sleep, but say remember “fuzzy

dinosaur” and then wake every 20 & ask what nonsense phrase was used

Disoriented Irritable Combative head dark color behind ears/raccoon eyes/ might want to include evacuate with any decrease in LOR

Sx as above Tx: monitor ABCs/backboard/elevate head 6-8”/EVAC

Shock: A+O3,4 (unless otherwise explained)/^HR/^RR/pale+cool+clammy = Compensatory | O↓/agitated/HR↓/RR^/PCC =

Decomp Cx: dehyd/ bleeding

Tx: find and treat the underlying cause control bleeding/maintain airway/calm/warm/elevate legs12”/fluids in extended

situations

CPR: 2 breaths; √ pulse; 30 comp+2br (rept 5x ); re √ pulse/resp

Diabetes: Give sugar

Abdominal EVAC? Abdominal pain+ S/Sx of shock+ Blood in vomit/,urine/feces+ Continuous pain>24O+ Localized pain,

rigidity/guarding/tenderness, Pain on movement, Nausea/ vomit/ runs causing dehydration or lasting >720,Fever >1020, S/sx

of PG (any of these individually should constitute an evacuation

Musculoskeletal Test: Look/Ask/Feel→ CirculationSensationMovement→ Passive RoM → Active RoM → Bear weight?→ Usable

HyRICE : Hydrate, Rest, Ice , Compress, Elevate. (NSAID)

Tx for ‘unusables’ & fracture: Traction → normal position STOP Traction if resistance or marked increase in pain

Splint: rigid , padded. Immobilize joints above & below fracture ( Bones above & below joint injury)

Splinting: Simple/Padded/Adjustable/fingers-toes available

Monitor CirculationSensationMovement before and after splinting For open fracture: Irrigate and dress 1

st! Start antibiotics!

Tx for dislocations: Reduce ASAP+ Slow, steady traction-in-line. Relaxation is key+ HyRICE , work ROM 3x/day this

should not be done before consulting a physician for a first time offender

EVAC: ↓ CirculationSensationMovement, unusable & 1st time dislocations.

Wounds

Control bleeding

Pressure & elevate; pressure on injury point

Tourniquet:, loosen/ retighten if needed these can be left in place for 2 hours with out damage, if your are applying

a tourniquet to a would you should be planning an evacuation for this pationt

Prevent infection: clean it!

Soap / H2O around wound

Remove foreign matter; scrub abrasions if needed

Pressure irrigate- only H2O

Dress & bandage ;gaping>1/2” pack w/damp gauze

Promote healing

Puncture: leave and stabilize in place Remove if: in cheek, extremity, cold metal from body core

EVAC: Impaled, Packed, Dirty/contaminated / bites, cosmetic, joints/genitals

Heat

Exhaustion: A+Ox4, HR/RR↑↓, SCTM: hot/red or pale/cool/clammy or dry Tx: cool pt/salty foods H2O/Electrolytes

Stroke: Change in LoR (- sign) Disoriented Irritable Combative head, SCTM: red/hot/dry this can vary, may be red/hot/moist,

pale/hot/dry. Tx: rapidly cool pt Life threatening: EVAC

Cold

DO NOT RUB frost-nip

Mild: “the umbles” poor motor skills

Moderate: ↓LoR (bad sign) uncontrolled shiver, ↑ umbles

Sever: NO shiver, stupor/unresponsive, NO CPR Life threatening: EVAC

Tx: warm/dry/no wind/warm food & drink/exercise if able, heat packs, hypo-wrap

Frostbite

Rewarm in 1060 H2O/ H2O in wrapped bottles in sleeping bag in groin, arm pits/or skin-to-skin

Rev: 26 Feb 09 Chris E. Stout, http:about.me?DrChrisStout