PATIENT ASSESMENT

AND
TRAUMA CARE

Patient Assessment
Scene Safety
The first Rule of Rescue

Do Not become ANOTHER victim

1. Is the Scene Safe?
2. What Happened?
3. How many Victims are
there?
4. Can anyone help?

Patient Assessment
A, B, C
Blood Sweep

H
C
A
P
E
R

Primary Assessment
Airway
Head Tilt

Jaw Thrust

A, B, C
NOTE:
rub the breastbone briskly
with a knuckle, or squeeze
the first or second toe over
the toenail

Primary Assessment

A, B, C

NOTE: If Air way is blocked due to injury the use of an Nasal

Pharyngeal my be the only way to obtain an air flow.

Primary Assessment
Breathing
Look
Listen
Feel

A, B, C
Circulation
Major
Bleeding

Patient Assessment
1

Blood Sweep
Identify MAJOR bleeding
Treat Quickly
Direct Pressure
3
Elevate
Pressure Points
Quick Clot
Can be applied first with injuries involving major arterial
bleeding.

Secondary Assessment
H HEAD
C CHEST
A ABDOMEN
P PELVIS
E

EXTREMITIES

R ROLL

Patient Assessment
HEAD
H
C
A
P
E
R

Visual and physical inspection

Deformities
Contusions
Abrasions
Punctures, Penetrations
Burns, Bleeding
Tenderness
Lacerations
Swelling

Patient Assessment
CHEST
H
C
A
P
E
R

Visual and physical inspection

Check Armpits as well

Patient Assessment
ABDOMEN
H
C
A
P
E
R

Visual and physical inspection

Check for unusual firmness and discoloration

Circular bruising around Belly Button

Patient Assessment
PELVIS
Visual and physical inspection

H
C
A
P
E
R

One fracture in the pelvis can bleed 0.5 liters / min

Patient Assessment

H
C
A
P
E
R

EXTREMITIES
Visual and physical inspection
Legs first
Then Arms

Patient Assessment
ROLL
H
C
A
P
E
R

Roll the Patient toward you.

Check the entire spine for Step offs or deviations
Rectum for bleeding

If Needed place litter under patient

Roll the patient back on the litter
Move to a safe location and reassess every 5 minutes for critical
patient and 15 minutes for non critical patient.

Trauma Care
Before providing any Trauma Care!!
The Scene Assessment is complete and all
known threats are neutralized.
Airway-Breathing-Circulation are checked and
intact.
Send for help and request required land/air
support.

Trauma Care
Three major types of open wounds
Penetration Injuries (Knifes, Bullets, Blasts)
Lacerations (Knifes, Sharp Metal, Blasts,
Glass)
Evulsions and Amputations (Blasts, Large
Caliber Weapons, Traffic Accidents)

Trauma Care
Penetration Injuries
Major causes include but are not limited to:
Blast injury, flying shrapnel
Bullets
Knives
Open wound extending through
the layers of skin and causing
damage to underlying tissue.
Most serious injuries can not
be seen
Minor external bleeding

Trauma Care
Lacerations
Major causes include:
Auto Accidents
Knives
Broken Glass
Any sharp objects
Lacerations can extend through
several or all layers of the skin.
Results may include
Major bleeding
Secondary infection

Trauma Care
Evulsions and Amputations
Major causes include:
Auto Accidents
Large Caliber weapons
Blast injuries
Rotational injuries
Can be complete or incomplete
Evulsions involve a flapping
of the skin.
Results may include
Major bleeding
Loss of limb

Trauma Care

Care for Bleeding Wounds

**Stop the Bleeding**
1. Apply direct pressure to the wound.
Use what ever you have available (hand or bandage)
2. While applying pressure, elevate the injured part above the level of
the heart (if no fractures).
3. Apply pressure to a pressure point.
4. Apply the appropriate amount of QuickClot into the wound.
5. Apply a Tourniquet
6. Treat for shock

Trauma Care
Pressure points

Trauma Care
Use the following guidelines for the application of QuickClot.
Apply direct pressure.
If moderate to severe bleeding continues after 1-2 minutes and
not controlled by pressure, apply QuickClot.
Hold package away from face and tear open.
Use a wiping motion to remove bandage and excess blood from
wound-quickly start to pour the product onto wound. Stop pour
when dry granules cover the wound completely.
Reapply direct pressure and bandage the wound
Attach empty package to the patient for transport.

Trauma Care
Extremities
Tourniquet
Apply tourniquet 2 to 4 inches
above wound, so that the
tourniquet is between the
wound and heart
Mark T on Forehead
Mark the time on body

Trauma Care
Fractures
Two types of fractures
Open fracture- Underlying bone has protruded through the
skin.
Bone or bone fragments may be visible at the wound site.
First priority is to control any major bleeding then treat
the fracture.
Closed fracture- Simple fracture where the continuity of the
skin remains intact.

Trauma Care
Fractures (cont)

Use the following guidelines to care for a fracture:

1. Control major bleeding
2. Stabilize the fracture site manually
3. Check PMS (pulse, movement and sensation)
4. Apply an immobilization device or improvised device.
5. Recheck PMS

Trauma Care

Two types of chest injuries

1.

Open (penetrating trauma)

2.

Could allow air to escape though the chest wall.

Lethal build-up of air or blood in the chest.

Closed chest wall injuries (flailed segment)

Reduces the effectiveness of the mechanics of breathing.

Painful to breath!

Trauma Care

Use the following guidelines for care of a penetrating chest injury:

1. Cover the wound with your gloved hand to control bleeding and to seal the wound.
2. Apply an occlusive dressing to the wound and seal on three sides. Keep the
lowest side unsealed to facilitate drainage.
Asherman Chest seal
Petroleum base gauze
Plastic or foil sheet
3. Watch for increasing signs of shortness of breath or difficulty in breathing. If you
note either of the above mentioned try burping the dressing. This action will not
be needed if you have a Asherman in place as the valve will allow continuous relief
of pressure.
Always look for and exit wound!!

Trauma Care
**remember to always check the back**

Trauma Care

Use of the Asherman Chest Seal

1. Use the gauze provided to
dry the area.
2. Peel the backing off the
adhesive patch.
3. Center the valve over the
injury site and completely
seal the patch on all sides.
4. Monitor patients Airway and
Breathing

Needle Chest Decompression

Trauma Care
Closed chest injuries (flailed Segments)
A flail chest occurs when a segment of the rib cage is separated from the
rest of the chest wall.
The segment of the chest wall that is flail is unable to contribute to lung
expansion.
To identify a flailed segment,
look for bruising, pain associated
with breathing and paradoxical
movement i.e. indrawing on
inspiration and moving outwards
on expiration.

Trauma Care
Closed chest injuries (cont)
Use the following guidelines to provide care for a flailed segment:
Ensure the Airway is clear and breathing is adequate.
Use a large bulky dressing or a pillow to stabilize the flailed
segment in place.
Continue to monitor the airway and breathing and be ready to
assist with rescue breathing.

Trauma Care
Abdominal Injuries
Exposed abdominal organs
Control major bleeding as described in previous slides
Protect exposed organs from contaminates and drying by
covering with a thin layer of plastic and a dressing. If need be
place any organs back onto the abdomen and then cover with
a dressing.
Place them on their back with the knees slightly bent. This
position is usually most comfortable for them.
Treat for Shock

Trauma Care

Care for Burns

1. Stop the burning process
Use what ever means available to stop the burning process.
2. Protect the airway
If the temperature was high enough to cause burns to the
upper body then there might be burns in the airways. Burns
in the airways cause swelling and accumulation of fluid.
3. Do not remove clothing that is stuck to the body.
4. Cover the patient with loose bulky dressing or clean sheet
5. Treat for shock

Trauma Care
Shock

Shock is a complication of injury and illness

Shock occurs when the body does not have a adequate blood
flow.
Three causes:
1.
2.
3.

Pump failure
Pipe failure
Fluid failure

Trauma Care
Signs and symptoms of shock include the following:

Anxiety or agitation
Confusion
Pale, cool, clammy skin
Bluish lips and fingernails
Dizziness, light-headedness, or faintness
Profuse sweating, moist skin
Rapid but weak pulse
Shallow breathing
Unconsciousness

Trauma Care
The following are guidelines for the treatment of shock

Check the A,B,C,s

Control any bleeding
Maintain body temperature
Elevate the feet 8-10 inches
Transport to a medical facility as soon as possible.
If trained, provide fluid recitation.

QUESTIONS

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Manual Carries (One Man)

Firemans Carry
Support Carry
Arms Carry
Pistol-belt Carry and Drag
Neck Drag

Firemans Carry

One-man Supported Carry

Saddleback Carry

Pack-Strap Carry

Manual Carries (two man)

Two man support carry

Two man arms carry
Two man fore-and-aft carry
Two hand seat carry

Two Man Supported Carry

Two Man Carry

Two Hand Seat Carry

Four-Hand Seat Carry

Two Person Fore and Aft Carry

Procedures For Carrying Litters

Movement should be deliberate and as gentle as possible.

Rear bearers move off of front bearers.
Keep litter as level as possible.
Carry casualty feet first. Except up hill, then head first.

LITTER TRANSPORTATION
Standard Litter

Pole less Litters

Rolled Blanket
Blouse/Flak
Blanket/Poncho