Trauma Physical Assessment

Question 1

Step 1 - DECAPBTLS

Answer 1

Check the head and neck for -
- Deformities
- Contusions (bruise)
- Abrasions (scrapes)
- Punctures
- Burns
- Tenderness
- Lacerations (cuts)
- Swelling

Question 2

Step 2 - Eyes

Answer 2

• Check the pupils for their dilation.

Question 3

Step 3 - Ears

Answer 3

• Check for blood or cerebral/spinal fluid.

Question 4

Halo Test

Answer 4

Take a piece of gauze, take a blood sample with the gauze from the ears, set off to the side and come back a few minutes later to see if there is separation of blood and spinal fluid.

Question 5

Step 4 - Nose/Mouth

Answer 5

Make sure airways are open

Question 6

Step 5 - Neck

Answer 6

Check for jugular vein distention (bulging veins) or tracheal deviation (trachea off to one side/not in normal placement). Both of these are signs that something is wrong with the lungs.

Question 7

Step 6 - Clothing

Answer 7

Take off clothes! “Not because we’re weird but because we need to see where they are hurt.”

Question 8

Step 7 - Chest

Answer 8

• Palpate (press down along the chest) for any pain.
• Make sure chest is rising equally during breaths.
• Check for broken ribs.

Question 9

Step 8 - Abdomen

Answer 9

• Check the four quadrants by palpating and rolling over.
• Check for distention (swelling). This is a sign of bloating.
• Check for hardness and hot temperature. This is a sign of blood in the area.

Question 10

Step 9 - Pelvis

Answer 10

Push down and in. Look for pain or crepitus (bone grinding noise).

Question 11

Step 10 - Legs

Answer 11

• Check one leg at a time all the way down. Remember to check for blood.
• Check for broken, hurting, bleeding.
• Check toes (have them wiggle if conscious)
• Check feeling (“Which toes am I touching?”)
• Check pulse at Dorsalis Pedis Artery (top of foot)

Question 12

Step 11 - Arms

Answer 12

• Check for Radial Pulse
• Go down arm to feel anything broken, hurting, bleeding
• Check feeling in fingers

Question 13

Step 12 - Noting

Answer 13

Notate any other injuries found on patient and remember all of this can be done in the ambulance.

Question 14

Step 13 - Vitals

Answer 14

Get a full set of vitals

Question 15

Timing on check up

Answer 15

5 minutes - Unstable Patients
15 minutes - Stable Patients