Lecture 1: Primary Assessment Flashcards
What are you looking for in a primary survey?
Looking for life threatening situations (unconcious, breathing, if they have a pulse/major bleeding)
How long should primary assessment take?
30-45 seconds max
What are you looking for in a secondary survey?
Head to toe assessment to check for limb threatening or less obvious injuries
What are the elements of a scene size up?
-Insuring my safety (safe for me, my athlete, has the play stopped, rules of the game?
-BSI (PPE)
(need gloves and protective wear)
-Location/position of patient/athlete
(dependant on the sport, athelete will be in various positions
–Number of victims as well as condition: traumatic or medical?
What are the 5 colours of triage tags?
Red, yellow green, black and white
What does the red triage tag mean?
Used to label those who cannot survive without immediate treatment but who have a chance of survival
What does the yellow triage tag mean?
For those who require observation. (stable for the moment with no immediate danger)
What does the green triage tag mean?
“walking wounded” who will eventually need care after the critical are treated
What does the black triage tag mean?
Used for deceased and for those whos injuries are so extensive they will not survive
What does the white triage tag mean?
Minor injuries where doctor care is not required
Where do you approach the patient from?
at the head (side thats facing you) FROM THE FEET
When do you stabilize the head>
INITIALLY, RIGHT AS YOU APPROACH THEM
What are some of the things you should not do when approaching your patient
- Do not approach from where they cannot see you
- Do not go over the patient (could injure further/bloack airway
- Never step over, always go around
How does blood look when it is flowing from an artery, a vein?
Artery: spurting must be blocked with pressure
-Steady flow (oozing)
As you approach the athlete, what are you looking for?
Position of athlete Skin colour Sweating Bleeding Deformity Assymetry Medic alert bracelet pupils sickness looking
If patient is semiprone where do you stabilize the head>
GO from the side, inforont of face
What is the acronym for the primary assessment?
UABCd
When would you usde UCABd instead?
If you do not see the MOI (do not know how long they have been down and need to assess if alive)
What does UABCd stand for>?
Unconciousness Airweay Breathing Circulation defib
What to ask to determine LOC
ASK:
What happened/open your eyes
(If no response: move to painful stimuli)
if response: WHere does it hurt, reach and squeeze my finger
What are the 2 types of painful stimuli and what are you looking for after administering
TRICEP PINCH/NAIL BED SQUEEZE
-do they open their eyes
-do they moan
-do thye localize the pain
do they withdraw from the pain?
What are the 2 methods of classifying level of conciousness
AVPU
Glasgow Coma Scale
Explain AVPU
A= alert (eyes are open and answering questions) CAN BE ORITENTED TO TIME PERSON PLACE EVEN
V= Response to verbal stimuli
M=Repsond to painful stimuli
U= no response to either verbal or painful and must call 911
What is the grading of glascow coma scale and what does each end mean?
EVM=Eye opening, verbal, motor
3-15
3= unconcious
15=fully awake and alert
If you find your patient to be unconcious, what is the first thing to do
SIGNAL FOR 911 AND activate erp
What to say when you call 911
- Status of paient
- age
- LOC, ABC staus
- vitals
- location, access speficics
- medical history
What does the A stand for in UABC
Airway
What are 3 ways of opening the airway
Trauma Jaw thrust
Head tilt/chin lift
trauma chin lift
Which way would you open the airway if you suspected a spinal injury?
Trauma jaw thrust
Name some possible airway obstructions
teeth food gum tongue vomit saliva/blood foreign body
Name the signs of obstructed airway
2-3 word dyspnea (shortness of breath)
use of accessory muscles for breathing
nasal flaring
laboured breathing
Should you immediately remove an athletes helmet?
no it is a last resort
Be able to identify the trauma jaw thrust, the head tilk chin lift and the trauma chin lift
.
What does the B in ABCs stand for ?
Breathing
What are the 3 things to do to assess breathing>
Look, listen, feel
What is a normal breathing rate?
12-20 respiration per minute
When should you assist breathing with a bag valve mask?
When breathing is less than 10 or greater than 30
What is circulation evaluated by?
the presence of a pulse
the character or a pulse
identification of external bleeding
evaluation of skin condition
What is considered a normal heart rate?
60-100 bpm
What do you do if no pulse is present?
Start CPR and Defib
name the different ways to provide artificial ventilation and the corresponding oxygen levels
-Barrier device
(your gas+02=50%)
- With bag valve mask and o2 delivers greater than 90%
- Non-breathing with NO pulse = CPR
Explain gastric distension
Can occur if blowing too hard or fast
can cause airway obstruction, vomitting and can reposition airway
Proper tecnique=
* Light breaths
* No manual pressure
What does OA stand for and what is its purpose
Oropharyngeal Airway
it keeps tongue from blocking upper airway, easier for suction, good airway maintenance
True or false
You can only use an OA for an unconcious patient>
True
What are the disadvantages of an OA
does not protect from aspiration
may stim vomitting and laryngospasm
if not inserted properly can actually push the tongue back and cause airway obstruction
How to you measure the OPA
Size from ear lobe to the corner of the mouth
What are the 3 insertion methods of an opa?
90 degrees
180 degrees
tongue depressor
When would you use an nasopharyngeal airway>
- For unconscious or semi- conscious patient
- For severe head trauma
- For “gag reflex”
- Need lubricant
How do you measure for a Nasopharyngeal airway>
Earlobe to the top of the nose concavely
HOw can you prevent shock
Supply O2 and give a blanket (to keep warmth)
What are the main GENERAL intervention steps for an unconcious patient?
1) ERP ready and visual scan with PPE
2) Approach from 45 degree on side where they can see you
3) Stabilize head and ask the questions/tricep pinch
4) Activate ERP and do the ABC’s
5) Insert OPA (if not gag reflex)
6) Head to toe palpation
What are the main GENERAL intervention steps for a concious patient?
- History / Chief complaint
- Evaluate injury
- ABC’s as required!
- Secondary assessment as required
