20091017 Class Notes - Afternoon

Post date: Oct 17, 2009 6:55:2 PM

Chapter Seven

Scene Size up

• 1. At the receipt of call and en route

     • Start self preparation (how to treat the patient)

     • BSI - Body Substance Isolation

     • Review equipment needs with the patient when you exit the ambulance

  2. Approaching the scene - establish danger zones

     • review danger zones

     • review hazardous materials

     • review for fire

  3. At the place of the call perform a Scene Size Up

     • Determine scene safety

     • Determine the mechanism of injury or the nature of the patient illness (if no trauma)

     • Determine the number of patients (check for additional patients)

     • Request additional help as required

Crime Scenes and Acts of Violence

• • Look for key indicators

    • Dark house

    • Lack of noise

    • Fighting or loud voices

    • Weapons visible or in use

    • Signs of alcohol or other drugs

    • Knowledge of prior violence

Review Mechanisms of injury and affected areas of the body

Chapter Eight

Goals of chapter eight - The Initial Assessment:

• • The general impression

  • Manual stabilization of the spine

  • Assessment of the mental status using the AVPU scale

  • The ABCs as part of the assessment process

  • How to make a priority decision

Study Guide for the initial assessment:

• Form a general impression of the patient

  • Is this a critical patient

  • Is this a complaint that is not critical

  • Is this a trauma complaint that is not life threatening?

  • Are we going to

    • Stay and Play

    • Load and Go

• Manual Stabilization of the Head and Neck

  • Applied to any patient that you suspect of an injury to the spine that is based on

    • mechanism of injury

    • history

    • signs and symptoms

  • Object is to hold the patient's head and neck in a neutral, in-line position

• Assess Mental Status

  • Alert: awake and oriented

  • Verbal: responds to verbal stimulus

  • Painful: responds to painful stimulus

  • Unresponsive: does not respond to any stimulus

• Assess Airway

• Assess Breathing

• Assess Circulation

• Determine priority

  • High-Priority Conditions:

    • Poor General Impressions

    • Unresponsive

    • Responsive, but not following commands

    • Difficulty breathing

    • Shock

    • Complicated childbirth

    • Chest pain with systolic blood pressure less than 100

    • Uncontrolled bleeding

    • Severe pain anywhere