Clinical Approach / Scenarios

Question 1

Normal Flow if WELL

Answer 1

1. Prearrival
2. Dangers
3. Rapid Assessment (to determine if patient is well OR unwell)
   - Alertness, skin, work of breathing

PATIENT IS WELL
4. ROPE acronym, introduce yourself

5. SAMPLE / history taking / DOLOR
6. VSS & Adjuncts (as applicable/appropriate)
7. Secondary Survey (as applicable/appropriate)
   - Trauma 2nd survey (physical examination)
   - Trauma 2nd survey (PILSDUCT, Neurovascular)
8. Social / Environmental factors

Question 2

Normal Flow if UNWELL

Answer 2

1. Prearrival
2. Dangers
3. Rapid Assessment (to determine if patient is well OR unwell)
   - Alertness, skin, work of breathing

PATIENT IS UNWELL
4. Primary Survey (including D & E)
4. ROPE acronym, introduce yourself (At same time if possible / once pt out of immediate danger

5. SAMPLE / history taking / DOLOR
6. VSS & Adjuncts at the same time
7. Social / Environmental factors

Question 3

Patient Assessment –> Secondary Survey Assessments

D.O.L.O.R

Answer 3

Pain assessment tool

D: Description
O: Onset and Trend
L: Location
O: Other symptoms
R: Relief and exacerbation
S: Severity

Question 4

Patient Assessment –> Secondary Survey Assessments

PILSDUCT (for fractures)

Answer 4

Fracture Assessment Tool

P: Pain (any pain in the region?)
I: Irregularity (unnatural protrusion, lumps, bumps, etc.)
L: Loss of Function (can they use part of body normally)
S: Swelling (Is the site swollen acutely)
D: Deformity (Angulation, rotation, displacement or shortening)
U: Unnatural movement (does part of body move in a way that it shouldn’t)
C: Crepitus (grinding of bone)
T: Tenderness

Question 5

Patient Assessment –> Secondary Survey Assessments

Neurovascular Assessment

Answer 5

Neurovascular assessment of limbs

P: Pain
S: Sensation
M: Motor Function
P: Perfusion

PERFUSION (5): CCPTS
1. Colour
2. Capillary refill
3. Pulse
4. Temp
5. Swelling

Question 6

Flow

Answer 6

1. Plan
2. Dangers
3. Rapid Assessment (well/unwell)
4. ROPE & SAMPLE/story of events
5. ASSESSMENTS
   - Vital signs (

Question 7

Rapid Assessment (3)

Answer 7

1. Alertness
2. Skin
3. work of breathing

Question 8

VSS & Adjuncts (8)

Answer 8

1. RSA
2. PSA
3. GCS
4. Temp
5. BGL
6. ECG
7. SPo2
8. EtCO2