Trauma Assessment Flashcards
What is the first step when attending a trauma
Checking for any dangers, and ensure that there is a safe scene to approach.
What is a safe scene approach?
Assessing and recognising if there are possible hazards present. Also what PPE will be required.
What initial patient assessment do we do?
Level of response (AVPU), general impression (end of bed assessment) -colour, eye contact, patient positioning, obvious pain.
If the patient is awake what must we do?
Gain consent
What is the first step after checking for danger in the primary survey?
Catastrophic Haemorrhage - assess the patient of life threatening external bleeding
What equipment can we use for catastrophic haemorrhage?
CAT Tourniquet, celox, russel chest seal
What is after catastrophic Haemorrhage?
Airway
How do we check a patients airway?
Open it by either a head tilt chin lift or a jaw thrust. Look inside for vomit, blood etc. Apply suction if required. Can use an OPA or a NPA to help keep the airway open.
After Airway what do we assess next?
Breathing
How do we assess breathing?
Get down to skin level, watch the chest rise and fall (is it equal). Auscultate and listen to the chest (what does it sound like). APPLY 100% OXYGEN WITH A NON REBREATHER MASK.
What is after breathing?
Circulation
How do we check circulation?
Can check breathiing and circulation simultaneously. While watching the chest rise and fall and check for a cararotid pulse. Check for radial pulses, temperature of the patients hands, colour, sweaty, clammy and also consider doing a capillarey refill time.
What is after circulation?
Disability
What does checking disability involve?
Checking the pupils - equal size, reactivity, direct resonse to light, consensual reflex, Pupils equal and reacting to light (pearl).
Consider blood glucose levels.
What is after checking the disbailty?
Expose and Examine
What does expose and examine consist of?
Removing all of the patients clothing, looking for obvious bleeding, deformity and bruising.
What is after the primary survey?
Secondary Survey
What is the purpose of a secondary survey
To identify and treat of any life threatening or limb threatening diseases.
What history take structure must we use when doing a secondary survey?
AMPLE - Alergies, Medication, Past medical History, Last meal, Events leading up to
Begins with D
What is the acronym when performing a head to toe exam?
DCAPBTLS - deformities, contusions, crepitus, abrasions, punctures, penetration,burns, tenderness, lacerations, swelling.
What is involved when completing a head to toe survey at the head?
Feel all over the head, check the hair - do not force open the eyes or mouth.
For conscious patients, what are we noting down about the radial pulse?
The rate, rhythm, strength
If the patient is not awake, how do we gain consent?
Work under the doctrine of necessity
What is agitation an early sign of?
Hypoxia and traumatic brain injury
What do you need to do as part of the secondary survey regarding the chest.
Full auscultation of all the lung fields when assessing the chest.
As part of the secondary survey what are we assessing in the neurological exam?
Calculating the GCS score, motor and sensory exam, pupils (important to reassess regularly).
If anything changes with the pts condition what do we do?
Reassess and return to the ABCDE process
Where do we start the head to toe exam?
The head
What should you do when checking the head in the head to toe exam?
Feel all over the head, red flags include boggy masses, battle signs, raccoon eyes, altered pupillary response.
What is after the head in the top to toe survey?
The neck
What are we assessing the neck for in the top to toe survey?
A central trachea, DCAPBTLS, feel for c-spine pain, tenderness, bony abnormalities, measure and apply collar, crepitus of the larynx, hoarseness, subcutaneous emphysema.
What is after the neck in the top to toe survey?
The chest
What are we checking the chest for in the top to toe survey?
DCAPBTLS, equal chest expansion, are there any open wounds. Need to do a full auscultation. IPPA
What is after the chest in the top to toe exam?
The abdomen
What are we checking the abdomen for in the top to toe survey?
Visual checks - signs of bleeding or bruising. Palpate all quadrants and stop when you feel pain!
What is after the abdomen in the top to toe survey?
The pelvis
What do we need to check the pelvis for in the top to toe exam?
If haven’t done so already apply pelvic binder. Unstable pelvic fractures can cause significant internal haemorrhage.
What is the last thing to check on the top to toe survey?
The back and limbs - DCAPBTLS and dress any wounds.
