Patient Assessment Model Chart (PAM)

Question 1

Delicate Spine: Critical Interventions

Answer 1

-Assess using NEXUS or Mechanism of injury
-Initiate head grip

Question 2

Delicate Spine: Maintain

Answer 2

FULL SPINAL IMMOBILIZATION
-apply c-collar (in neutral position)
-Blanket/strap legs
-Body secured to immobilization device
-Secure head (foam rolls/Sam)

Question 3

Level of Consciousness

Answer 3

AVPU
-Alert
-Verbal
-Painful
-Unresponsive

Question 4

AIRWAY - Critical Interventions: To open mouth

Answer 4

-Cross finger technique
-Tongue jaw lift

Question 5

AIRWAY - Critical Interventions: To clear

Answer 5

-Suction
-Finger sweep

Question 6

AIRWAY - Critical Interventions:
To open

Answer 6

-Head tilt chin lift
-Jaw thrust

Question 7

AIRWAY - Critical Interventions: To maintain

Answer 7

-OPA
-NPA
-3/4 Prone, recovery or HAINES position
-Manual maneuvers

Question 8

AIRWAY - Critical Interventions: Airway obstruction

Answer 8

-Back blows
-Abdominal thrusts
-Manual maneuvers

Question 9

AIRWAY - Maintain

Answer 9

Insert airway adjunct:
-Oropharyngeal airway (OPA)
-Nasopharyngeal airway (NPA)

Question 10

BREATHING - Critical interventions

Answer 10

Assisted ventilations using bag valve mask
-Bag valve mask

Supplemental oxygen administration
-Nasal cannula
-Standard/simple face mask
-Non-rebreather

Question 11

BREATHING - Maintain

Answer 11

Consider bringing extra set of hands during transport

Question 12

CIRCULATION - Critical interventions

Answer 12

No carotid pulse:
-Initiate Cardiopulmonary Resuscitation (CPR) protocol

If you suspect patient is in cardiac arrest check pulse initially in primary survey using CAB assessment

Question 13

CIRCULATION - Maintain

Answer 13

Continue chest compressions/AED as directed by CPR protocol and continue primary survey

Question 14

RAPID BODY SURVEY - Critical interventions

(always wear appropriate PPE e.g. gloves, goggles, gown)

Answer 14

CUT AND EXPOSE when pain or injury suspected and CHOOSE APPROPRIATE CRITICAL INTERVENTIONS from Traumatic injury chart when necessary

Question 15

RAPID BODY SURVEY - Maintain (list of bandages)

(always wear appropriate PPE e.g. gloves, goggles, gown)

Answer 15

Options for bandages to secure dressings include:
- Zap strap
- Tensor bandage
- Crepe bandage
- Roller bandage
- Triangular bandage
- Trans-pore tape
(Choose based on level of pressure required)

Question 16

SKIN - Critical Interventions

Answer 16

• Assess for signs and symptoms of shock (colour/temp/perspiration)
• Consider blanket

Question 17

OXYGEN - Critical Interventions

Answer 17

APPLY OXYGEN (if required):
- Nasal cannula
- 1-6 Lpm flow rate
(“Low-concentration mask”)

STANDARD MASK
- 6-10 Lpm flow rate
(“Medium concentration mask”)

NON-REBREATHER MASK
- 10-15 Lpm flow rate
(“High concentration mask”)

Question 18

AIRWAY - Critical intervention:
General

Answer 18

Re-confirm airway is still maintained (OPA/NPA) and is still patent. If not, address with critical interventions:

• Suction
• Finger sweep
• Insert OPA/NPA
• Recovery position

Question 19

ASCULTATION - Critical interventions

Answer 19

Only if in respiratory distress due to a medical cause

• Auscultate 6 points of the lungs

Question 20

POSITIONING - Critical interventions: If Alert

Answer 20

Position of Comfort

Question 21

POSITIONING - Critical interventions: If in respiratory distress

Answer 21

Semi-Fowlers/Fowlers

Question 22

POSITIONING - Critical interventions: If assisting in ventilations or spinal motion restriction

Answer 22

Supine

Question 23

POSITIONING - Critical interventions: If decreased level of consciousness

Answer 23

Recovery position

Question 24

POSITIONING - Critical interventions: If showing signs and symptoms of shock or hypotension (absent radial pulses)

Answer 24

Supine

Question 25

PROTOCOLS - Critical interventions

Answer 25

Consider entering EMR protocol on scene

Question 26

PACKAGING OF INTERVENTIONS - Maintain

Answer 26

Package up all critical interventions for transport