Finding Out Whats Wrong- Assessing The Victim

Front 1

define victim assessment overview:

Back 1

A victim assessment is a sequence of actions that
helps determine what is wrong

Front 2

A primary check will determine if: (3)

Back 2

— There is injury or illness
— Whether the victim is responsive or unresponsive
— If a life threatening condition exists

Front 3

Assessment Steps (5)

Back 3

1. Scene size-up / survey the scene
2. Primary check
3. Secondary check
4. SAMPLE history
5. Reassessment

Front 4

(Scene Size-Up) look for:

Back 4

hazards

Front 5

(Scene Size-Up): notice...

Back 5

the potential for violence

Front 6

(Scene Size-Up): be observent of...

Back 6

weapons

Front 7

(Scene Size-Up): reduce exposure to...

Back 7

potentially dangerous body substances

Front 8

(Scene Size-Up): detemine...

Back 8

weather the problem is an injury or an illness

Front 9

Primary Check:

Back 9

Identify life threatening conditions so that you can
immediately take action to treat the conditions

Front 10

how do you identify life threatening conditions?

Back 10

— Responsiveness
— Circulation
— Breathing
— Severe bleeding

Front 11

Primary Check: form a first response...

Back 11

— Responsive or unresponsive
— Breathing adequately?
— Injury or illness?
— Talking?
— Severe bleeding?
— Chance of exposure to blood or body fluids?
— Danger to you, victim, or bystanders?

Front 12

how do you check responsiveness?

Back 12

Tap the victim on the
shoulder and ask, “Are
you okay?”
— Use the AVPU Scale

Front 13

Alert Victim
— Evaluate ability to remember (4)

Back 13

— Person- What is your name?
— Place- Do you know where you are?
— Time- What are the month and year?
— Event- What happened?

Front 14

Unresponsive Victim: (RAP-CAB): R

Back 14

R = Responsive?
— Tap shoulder and shout, “Are you okay?”

Front 15

Unresponsive Victim: (RAP-CAB): A

Back 15

A = Activate
— Activate emergency medical services (EMS)

Front 16

Unresponsive Victim: (RAP-CAB): P

Back 16

P = Position
— Position the victim on his/her back
**** If no cervical/spinal injury is suspected ****

Front 17

Unresponsive Victim: (RAP-CAB): C

Back 17

C = Cardiopulmonary resuscitation (CPR)

Front 18

Unresponsive Victim: (RAP-CAB): A

Back 18

A = Airway, open the airway

Front 19

Unresponsive Victim: (RAP-CAB): B

Back 19

B = Breaths

Front 20

Checking for Breathing

Back 20

— Chest movement
— Normal and abnormal
breath sounds
— Feeling adequate air
movement

Front 21

Checking for Severe Bleeding

Back 21

— Check for a large amount of blood
— --Around the victim
— --On the victim’s clothing

Front 22

should most victims be moved?

Back 22

no

Front 23

exceptions to not moving the victim

Back 23

— Unsafe location
— Victim is face down and needs CPR
— Victim has difficulty breathing from vomit or
secretions
— First aider is alone and must leave to get help

Front 24

HAINES Position

Back 24

laying on your side with one arm up

Front 25

Secondary Check

Back 25

— Determine whether
the cause or
mechanism of injury
was significant
— Assume a victim
with a head injury
has a spinal injury

Front 26

Secondary Check (how to check for a responsive victim)

Back 26

— Ask if he/she can feel or wiggle the fingers and toes
— Ask them to squeeze your hand, push foot against your hand

Front 27

Secondary Check (how to check for a responsive victim)

Back 27

Check spinal cord with Babinski reflex test

Front 28

Babinski Reflex: the presence of a Babinski's reflex after age 2 is a sign of....

Back 28

The presence of a Babinski's reflex after age 2 is a
sign of damage to the nerve paths connecting the
spinal cord and the brain

Front 29

Babinski Reflex (signs)

Back 29

— See
— Feel
— Hear
— Smell

Front 30

Babinski Reflex: symptoms

Back 30

— Things the
victim feels
— Things the
victim can
describe
— Chief complaint

Front 31

Secondary Check: Vital Signs (6)

Back 31

— Pulse
— Blood Pressure
— Respiratory Rate
— Temperature
— Pulse Oximetry
— Pain Assessment

Front 32

when critically ill/injures you should check vital signs how frequently

Back 32

at least every 3 min

Front 33

when there is a less seriously injured person you should check vital signs how frequently

Back 33

intervals of 5-15 min

Front 34

pulse

Back 34

Surge of blood that occurs each time that the heart
contract
-Directly reflects the rhythm, relative strength, and
rate of contraction of the heart
-Can be felt at any point where an artery lies near
the skin surface

Front 35

how long do you need to check a pulse for full accuracy?

Back 35

1 minute

Front 36

strength of a pulse (weak)

Back 36

“thready,” may be in shock

Front 37

stength of a pulse (bounding)

Back 37

unusually strong

Front 38

normal pulse rate for an adult

Back 38

60-100bpm

Front 39

normal pulse for a child

Back 39

80-100bpm

Front 40

normal pulse for an infant

Back 40

120-140 bpm

Front 41

where can you check for a pulse?

Back 41

— Carotid artery
— Brachial artery *
— Radial artery *
— Femoral artery
— Posterior tibial artery
— Dorsal pedal artery

Front 42

where is cartoid artery?

Back 42

kneck

Front 43

where is brachial artery

Back 43

bicep

Front 44

where is radial artery

Back 44

wrist

Front 45

where is femoral artery

Back 45

hip

Front 46

where is posterior tibial artery

Back 46

inside of heel

Front 47

where is dorsal pedal artery

Back 47

on top of foot

Front 48

blood pressure indicates

Back 48

Indication of the force exerted by blood on the vessels walls

Front 49

what changes blood pressure?

Back 49

Affected by changes in blood volume and heart rate

Front 50

Cuff collapses artery =

Back 50

turbulent blood flow (Korotkoff sounds)

Front 51

Systolic BP- ventricular
contraction

Back 51

top number

Front 52

Diastolic BP- ventricular
relaxation

Back 52

bottom number

Front 53

normal BP

Back 53

< 120/80 mmHg

Front 54

PRE-HYPERTENSION BP

Back 54

120-139/80-89 mmHg

Front 55

hypertension BP

Back 55

>140/90 mmHg

Front 56

how to take blood pressure (8 steps)

Back 56

— Victim should be lying or sitting down
— Place cuff around arm, just above the elbow
— Arrow on cuff should be placed over brachial artery
— Close the valve on the bulb completely
— Place stethoscope under the cuff, over the artery
— Inflate the cuff by pumping the bulb to 220 mmHg
— Slowly deflate cuff
— Listen for first (systolic) and last (diastolic) beat

Front 57

What if you do not have a stethoscope to take BP

Back 57

Use systolic BP / palpation technique

Front 58

what readings could you get if the cuff is too small?

Back 58

falsely high readings

Front 59

what readings could you get if the cuff is too big?

Back 59

falsely low readings

Front 60

what is the vital function of respiration?

Back 60

gas exchenge

Front 61

what is respiration controlled by?

Back 61

the brain

Front 62

is respiration activity dependent?

Back 62

yes!

Front 63

respiration (increases/decreases) at rest
respiration (increases/decreases) with activity

Back 63

— Decreases at rest
— Increases with activity

Front 64

depth of respiration

Back 64

— Rise and fall of chest/abdomen
— Ease/difficulty of breathing

Front 65

describe normal respiration

Back 65

very little effort, not painful

Front 66

distressed respiration

Back 66

wheezing, gurgling, flaring nostrils, painful

Front 67

adult respiration _ breaths pm

Back 67

12-20

Front 68

child respiration _ breaths per minute

Back 68

15-30

Front 69

infant respiration _ breaths per minute

Back 69

25-30

Front 70

do athletes alter their breathing parrern?

Back 70

yes

Front 71

how long should you assess breathing?

Back 71

30 seconds

Front 72

1st 30 seconds =

Back 72

pulse check

Front 73

2nd 30 seconds =

Back 73

respiratory count

Front 74

rapid respiratory rate =

Back 74

tachypnea

Front 75

what causes tachypnea?

Back 75

Anxiety, pain, excitement, acidosis

Front 76

Slow respiratory rate =

Back 76

bradypnea

Front 77

what causes bradypnea?

Back 77

Head injury, drug overdose

Front 78

Irregular pattern + head injury =

Back 78

emergency
-Cheyne-Stokes Respirations

Front 79

what do you need to check on a person if heat illness is suspected?

Back 79

temperature

Front 80

Gold standard for accurate readings for temperature

Back 80

— Rectal temperature
— Tympanic
— Oral
— Axillary or skin

Front 81

when taking temperature always take note of....

Back 81

the method you used... (orally, anally, superficial)

Front 82

oximeter provides...

Back 82

a % of hemoglobin

Front 83

Pulse Oximetry

Back 83

Mandatory monitor while under sedation

Front 84

normal Pulse Oximetry =

Back 84

99-100%

Front 85

AT & Pulse Oximetry: Large athlete in supine position

Back 85

90-95%
take a few deep breaths

Front 86

Possible interferences with AT and pulse oximetry

Back 86

— Cold fingers
— Low blood pressure
— Bright ambient light
— Fast or irregular pulse

Front 87

AT and pulse oximetry measures _ not ventilation

Back 87

saturation

Front 88

when concentrating on a skin condition you need to look at (3)

Back 88

— Color
— Temperature
— Moisture

Front 89

when looking at a skin condition you need to look at skin temperature/moisture

Back 89

-

Front 90

Secondary Check: DOTS

Back 90

— D = Deformity
— O = Open wounds
— T = Tenderness
— S = Swelling