Medical and Trauma

Question 1

What is BSI/SS?

Answer 1

BSI/SS
❑ PPE
❑ You, your crew, bystanders, THEN the patient
❑ Chemical spill? Violence? Gasses? Unstable
conditions?

Question 2

Mechanism of Injury

Answer 2

❑ Can give you an idea of the injuries to the patient

❑ Look at the scene, ask bystanders

Question 3

C-Spine Considerations

Answer 3

❑ Hold the head in a neutral position

❑ Check for Additional Patients

Question 4

Consider Additional Resources

Answer 4

(ALS, Heavy Rescue, Fire

Marshalls, FD, PD)

Question 5

Initial Assessment Acronym

Answer 5

(GMC ABCDU)

Question 6

General Impression:

Answer 6

your first look at the patient (brief description)

❑ Age, sex, position found, major signs/symptoms
❑ “22 y/o male found lying supine on the sidewalk with an obvious
deformity to the right tib-fib screaming in pain”
❑ “19 y/o female found unresponsive hunched on the couch with depressed
respirations next to an empty oxycodone bottle”
❑ Include pertinent information!

Question 7

Mental Status:

Answer 7

Person, Place, Time, Situation

❑ Person: Who is the president? Who is this person? What is your name? (if
you know it and can confirm)
❑ Place: Where are you right now?
❑ Time: What year/month/time of the day is it?
❑ Situation: Why was the ambulance called today?

Question 8

Mental Status AVPU:

Answer 8

❑ Alert and Oriented x4
❑ Verbally Responsive
❑ Painfully Responsive
❑ Unresponsive

Question 9

Chief Complaint:

Answer 9

What is bothering the patient the most?

❑ PCR Things: record what the patient says in their own words, in quotes
❑ May not align with what you think is the most significant sign/symptom
❑ NOT what you think, it’s what they patient SAYS
❑ If not alert (they are V/P/U) their chief complaint is “AMS”

Question 10

Airway

Answer 10

❑ Is the airway open? – Can they talk? Check for obstructions (including
tongue)
❑ Jaw Thrust vs Head-Tilt, Chin-Lift
❑ Will the airway stay open?
❑ Is there anything I need to take out? - Suction
❑ Teeth, blood, mucus
❑ Careful of fingers
❑ Is there anything I need to put in? – OPA/NPA
❑ Snoring?
❑ Know indications/contraindications
❑ Keep monitoring!

Question 11

Breathing (ELPASSCO)

Answer 11

❑ Expose
❑ Look for DCAP BTLS
❑ Palpate (clavicles, sternum walk, ribs)
❑ Auscultate 6 Point Lung Sounds (midclavicular, midaxillary, basal)
❑ Seal
❑ Stabilize
❑ Compare Breathing to your own, determine if adequate
❑ Oxygen Therapy

Question 12

Circulation (PEST)

Answer 12

❑ Pulse (Radial): rhythm and quality (get a quick impression of circulation)
❑ External blood sweep
❑ Stop and treat any life threatening bleeds (venous/arterial)
❑ Skin: color, temperature, condition
❑ Warm, pink (perfused), unremarkable vs cool, pale, diaphoretic
❑ Treat for Shock (if applicable)
❑ High Flow O2, ALS, Rapid Transport, Thermoregulation, Trendelenburg
Position

Question 13

Decision:

Answer 13

Stay and Play or Load and Go?
❑ Determine priority of patient
❑ Trauma = Load and Go!
❑ Platinum 10: 10 minutes from arrival on scene to off scene departure
❑ Golden Hour: 1 hour from the time of injury to the time of care/surgery

Question 14

Update ALS

Answer 14

❑ If you signaled for them in scene size up
❑ Include patient’s condition, any treatments you performed
❑ Can meet them on the way to the hospital