Trauma Assessment

Question 1

What is the first step when attending a trauma

Answer 1

Checking for any dangers, and ensure that there is a safe scene to approach.

Question 2

What is a safe scene approach?

Answer 2

Assessing and recognising if there are possible hazards present. Also what PPE will be required.

Question 3

What initial patient assessment do we do?

Answer 3

Level of response (AVPU), general impression (end of bed assessment) -colour, eye contact, patient positioning, obvious pain.

Question 4

If the patient is awake what must we do?

Answer 4

Gain consent

Question 5

What is the first step after checking for danger in the primary survey?

Answer 5

Catastrophic Haemorrhage - assess the patient of life threatening external bleeding

Question 6

What equipment can we use for catastrophic haemorrhage?

Answer 6

CAT Tourniquet, celox, russel chest seal

Question 7

What is after catastrophic Haemorrhage?

Answer 7

Airway

Question 8

How do we check a patients airway?

Answer 8

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.

Question 9

After Airway what do we assess next?

Answer 9

Breathing

Question 10

How do we assess breathing?

Answer 10

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.

Question 11

What is after breathing?

Answer 11

Circulation

Question 12

How do we check circulation?

Answer 12

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.

Question 13

What is after circulation?

Answer 13

Disability

Question 14

What does checking disability involve?

Answer 14

Checking the pupils - equal size, reactivity, direct resonse to light, consensual reflex, Pupils equal and reacting to light (pearl).
Consider blood glucose levels.

Question 15

What is after checking the disbailty?

Answer 15

Expose and Examine

Question 16

What does expose and examine consist of?

Answer 16

Removing all of the patients clothing, looking for obvious bleeding, deformity and bruising.

Question 17

What is after the primary survey?

Answer 17

Secondary Survey

Question 18

What is the purpose of a secondary survey

Answer 18

To identify and treat of any life threatening or limb threatening diseases.

Question 19

What history take structure must we use when doing a secondary survey?

Answer 19

AMPLE - Alergies, Medication, Past medical History, Last meal, Events leading up to

Question 20

Begins with D

What is the acronym when performing a head to toe exam?

Answer 20

DCAPBTLS - deformities, contusions, crepitus, abrasions, punctures, penetration,burns, tenderness, lacerations, swelling.

Question 21

What is involved when completing a head to toe survey at the head?

Answer 21

Feel all over the head, check the hair - do not force open the eyes or mouth.

Question 22

For conscious patients, what are we noting down about the radial pulse?

Answer 22

The rate, rhythm, strength

Question 23

If the patient is not awake, how do we gain consent?

Answer 23

Work under the doctrine of necessity

Question 24

What is agitation an early sign of?

Answer 24

Hypoxia and traumatic brain injury

Question 25

What do you need to do as part of the secondary survey regarding the chest.

Answer 25

Full auscultation of all the lung fields when assessing the chest.

Question 26

As part of the secondary survey what are we assessing in the neurological exam?

Answer 26

Calculating the GCS score, motor and sensory exam, pupils (important to reassess regularly).

Question 27

If anything changes with the pts condition what do we do?

Answer 27

Reassess and return to the ABCDE process

Question 28

Where do we start the head to toe exam?

Answer 28

The head

Question 29

What should you do when checking the head in the head to toe exam?

Answer 29

Feel all over the head, red flags include boggy masses, battle signs, raccoon eyes, altered pupillary response.

Question 30

What is after the head in the top to toe survey?

Answer 30

The neck

Question 31

What are we assessing the neck for in the top to toe survey?

Answer 31

A central trachea, DCAPBTLS, feel for c-spine pain, tenderness, bony abnormalities, measure and apply collar, crepitus of the larynx, hoarseness, subcutaneous emphysema.

Question 32

What is after the neck in the top to toe survey?

Answer 32

The chest

Question 33

What are we checking the chest for in the top to toe survey?

Answer 33

DCAPBTLS, equal chest expansion, are there any open wounds. Need to do a full auscultation. IPPA

Question 34

What is after the chest in the top to toe exam?

Answer 34

The abdomen

Question 35

What are we checking the abdomen for in the top to toe survey?

Answer 35

Visual checks - signs of bleeding or bruising. Palpate all quadrants and stop when you feel pain!

Question 36

What is after the abdomen in the top to toe survey?

Answer 36

The pelvis

Question 37

What do we need to check the pelvis for in the top to toe exam?

Answer 37

If haven’t done so already apply pelvic binder. Unstable pelvic fractures can cause significant internal haemorrhage.

Question 38

What is the last thing to check on the top to toe survey?

Answer 38

The back and limbs - DCAPBTLS and dress any wounds.