Chapter 11 Scene Size Up

Question 1

Scene Size Up

Answer 1

first part of the patient assessment process

Question 2

When arriving to a scene with Emergency personal there?

Answer 2

• Always perform your own scene size up

- Scan for hazards, infection control, MOI or NOI and number of patients

Question 3

As you Near a collision/scene you?

Answer 3

• look and listen for other Emergency services
• look for signs of power outages
• observe traffic flow
• look for smoke in direction of scene

Question 4

When you are in sight of scene you?

Answer 4

• look for clues indicating escaped hazardous materials like gas, oil, chemicals
• Look for collision victims on or near scene/road
• Look for broken utility poles or downed wires
• alert for people on side of roads

Question 5

As you reach scene you?

Answer 5

• follow instruction of person in charge
• wear appropriate PPE and be BSI scene safe
• determine where to find patient
• be aware of hazards

Question 6

Danger Zone

Answer 6

Area around the wreckage of a vehicle collision or other incident wishing which special safety precautions should be taken

Question 7

When there are no apparent hazards in danger zone?

Answer 7

stay 50 ft in all directions from wreckage

Question 8

When fuel has been spilt in danger zone?

Or When vehicle is on Fire?

Answer 8

stay a minimum of 100 ft away in all directions

• park upwind if possible
• park uphill if possible
• mainly don’t be near flowing fuel

Question 9

When wires are down in danger zone?

Answer 9

Stay at least one full span of wires away from the pole that the broken wires are attached too

Question 10

When Hazardous Material is involved in danger zone?

Answer 10

Some cases you will be 50 ft away other cases you may have to be 2000ft or more away
- all cases park upwind from scene and away from flowing liquid

Question 11

Signals or signs of a Dangerous scene from Violence

Answer 11

• Fighting or loud noises
• Weapons visible or in use
• Signs of alcohol or other drug use
• Unusual Silence
• Knowledge of prior violence

Question 12

Mechanism of Injury (MOI)

Answer 12

A force or forces that may have caused an injury

Question 13

In motor vehicle crashes there are three collisions:

Answer 13

1. vehicle striking an object
2. Patients body sticking the interior of the vehicle
3. occurs when organs of patient strike the surfaces within the body

Question 14

Law of inertia

Answer 14

A body in motion will remain in motion unless acted upon by an outside force

Question 15

Head on Collisions: injury patterns

Answer 15

1. up-and-over pattern
   - injuries include: Head, Neck, Chest, abdomen, internal organs and breathing problems
   - check windshield, steering wheel, Dash for MOI
2. down-and-under pattern
   - injuries include: knee, leg and hip injuries
   - Check pedals, steering wheel for MOI

Question 16

Rear end collisions: injury patterns

Answer 16

causes neck and head injuries

Question 17

Side Impact Collisions: injury patterns

Answer 17

Injuries include: Head, neck, chest, abdomen, pelvis, and thighs. Also might cause internal organ damage

Question 18

Rollover collisions and Rotational impact collisions: Injury Patterns

Answer 18

Rollovers are the most serious collision because of potential for multiple impacts
- Rotational can also cause multiple injuries

Question 19

Falls: important factors to consider

Answer 19

• Height
• surface
• part of patient that hit surface
• anything that interrupts the fall
• Expect damage to Transmit/Flow to adjoining parts of body

Question 20

General Guideline of severe fall height

Answer 20

• Fall of greater than twenty feet for an adult
• Greater than ten feet for a child under fifteen
• or more than two to three times child’s height
  Are all sever falls and should be considered for High priority and transport

Question 21

Penetrating Trauma: Classifications

Answer 21

1. Low velocity
   - those propelled by hand such as knives, limited to area that was penetrated
2. Medium Velocity
   - Caused by either: Handguns, shotguns, compound bow, Ballistic Knife
3. High Velocity
   - Caused by high powered rifles or assault rifles
   
   • Damage by bullet like Size of bullet, Fragments, and deflection once inside body
     - Damage by pressure - energy of bullet can cause considerable damage to area around bullet

Question 22

Index of suspicion

Answer 22

Awareness that there may be injuries

Question 23

Blunt Force Trauma

Answer 23

Injury caused by a blow that strikes the body but does not penetrate the skin or other body issues

Question 24

NOI Nature of Illness

Answer 24

What is medically wrong with a patient

• Three ways to find out
  1. The patient - prime source of info if conscious
  2. Family or Bystanders - when patient is unconscious or has an AMS
  3. The Scene - factors like medication, dangerous or unsanitary living conditions

Question 25

Number of Patients and resources

Answer 25

Alway request resources if there are more then on patient or if there is factors that inhibit optimal care and safety