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Patient Assessment | Part Two

Phases of Scene Assessment (Continued)

3 – Focused History and Physical Exam Medical

Medical: Limited and is specifically related to the acute problem of the day. Use OPQRST

  • Assess: what ever is related to the complaint
  • Take: baseline vitals

Unresponsive Medical: do a rapid assessment
Position patient to protect the airway

Assess:

  • Head
  • Neck
  • Chest
  • Abdomen
  • Pelvis
  • Extremities
  • Posterior

Take: Baseline vitals, SAMPLE history from family, bystanders
Look for: medical tags

4 – Focused History and Physical Exam Trauma

Trauma: What is the mechanism of injury? Prioritize/make a transport decision based on:

  • Ejection from the vehicle
  • Death in the passenger compartment
  • Fall of more than 20 feet
  • Vehicle rollover
  • High speed crash
  • Vehicle vs. Pedestrian crash
  • Motorcycle crash
  • Unresponsive or altered mental status
  • Penetration of head, chest, abdomen

Infants/Small Children

  • Falls of more than 10 feet
  • Bicycle collisions
  • Passenger in any medium speed collision

Rapid Trauma – look for:

  • Deformity
  • Contusions
  • Abrasions
  • Penetration/punctures
  • Burns
  • Tenderness
  • Lacerations
  • Swelling

No Mechanism of Injury?

  • Focused history and physical exam of injuries
  • Assess baseline vitals
  • Obtain a patient history

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