Ch04 presentation finding_out_what_is_wrong
- 1. Chapter 4 Finding Out What is Wrong
- 2. Assessment Overview • Assessment: Sequence of actions that helps determine what is wrong • A primary check will determine: − Illness or injury − Responsiveness or unresponsiveness − Existence of life-threatening condition
- 3. Assessment Overview © Jones & Bartlett Learning.
- 4. Assessment Steps • Perform a primary check. • Perform a physical exam. • Obtain the person’s SAMPLE history.
- 5. Scene Size-up • Look for hazards. • Be aware of the potential for violence. • Be observant for weapons. • If scene appears hazardous, do not go in. • Reduce exposure. • Determine whether problem is injury or illness.
- 6. Primary Check • Identify life-threatening conditions so that you can immediately take action to treat the conditions. − Responsiveness − Circulation − Breathing − Severe bleeding
- 7. Primary Check • Form a first impression. − Injury or illness? − Responsive or unresponsive? − Breathing adequately? Talking? − Bleeding? − Chance of exposure to blood or body fluids? − Danger to you, injured or ill person, or bystanders?
- 8. Primary Check • Check responsiveness. − Tap the person on the shoulder and ask, “Are you okay?” • If the person does not respond, call 9-1-1. • If you cannot detect breathing, begin CPR.
- 9. Primary Check • Check for breathing. − Chest movement − Normal and abnormal breath sounds − Cyanosis and skin color © Jones & Bartlett Learning.
- 10. Primary Check • Check for severe bleeding. − Check for a large amount of blood. • Around the person • On the person’s clothing − Control bleeding. − Wear exam gloves.
- 11. Primary Check • Position the person. − Most people should not be moved. − Exceptions: • Unsafe location • Person is face down and needs CPR • Person has difficulty breathing from vomit • First aid provider must leave to get help • Signs of shock develop
- 12. Placing an Unresponsive Breathing Person in the Recovery Position • Kneel next to the person’s side. • Straighten both legs. • Place the arm nearest you out from the body. © Jones & Bartlett Learning.
- 13. Placing an Unresponsive Breathing Person in the Recovery Position • Bring the other arm across the person’s chest. • Grab and raise the far knee until it is bent. © Jones & Bartlett Learning. © Jones & Bartlett Learning.
- 14. Placing an Unresponsive Breathing Person in the Recovery Position • Grab the person’s bent knee and shoulder and roll the person toward you, onto the side. © Jones & Bartlett Learning.
- 15. Placing an Unresponsive Breathing Person in the Recovery Position • Adjust the top leg so that both the knee and the hip are bent at right angles. • Keep the top hand under the person’s cheek. © Jones & Bartlett Learning. © Jones & Bartlett Learning.
- 16. Physical Exam • Determine whether the cause of injury was significant. − Assume a person with a head injury also has a spinal injury.
- 17. Physical Exam • For a responsive person − Ask if he or she can feel or wiggle the fingers and toes. • For an unresponsive person − If you suspect a spinal injury, do not move the person’s head or neck.
- 18. Physical Exam • Assess the person’s entire body. − Signs—conditions you can see, feel, hear, and smell − Symptoms—things the person feels and is able to describe • The chief complaint
- 19. Physical Exam • D = Deformity • O = Open wounds • T = Tenderness • S = Swelling © American Academy of Orthopaedic Surgeons. © Jones & Bartlett Learning. Courtesy of MIEMSS. © Johnathan Noden- Wilkinson/ShutterStock. © American Academy of Orthopaedic Surgeons.
- 20. Significant Cause of Injury • Check the head. • Check the eyes. • Check the ears and nose. • Check the mouth. © Jones & Bartlett Learning. Courtesy of MIEMSS.
- 21. Significant Cause of Injury • Check the neck. • Check the chest. − Gently press inward. © Jones & Bartlett Learning. Courtesy of MIEMSS. © Jones & Bartlett Learning. Courtesy of MIEMSS.
- 22. Significant Cause of Injury • Check the abdomen. − Gently press on all four quadrants. © Jones & Bartlett Learning. Courtesy of MIEMSS.
- 23. Significant Cause of Injury • Check the pelvis. − Gently press inward on tops of hips. − Press downward. © Jones & Bartlett Learning. Courtesy of MIEMSS.© Jones & Bartlett Learning. Courtesy of MIEMSS.
- 24. Significant Cause of Injury • Check all four extremities. − Circulation − Sensation − Movement • Check the back. © Jones & Bartlett Learning. Courtesy of MIEMSS.
- 25. Special Considerations • Skin condition − Temperature − Color − Moisture © Jones & Bartlett Learning. © Jones & Bartlett Learning.
- 26. Special Considerations • Capillary refill test − Press fingernail or toenail for a few seconds and release. © American Academy of Orthopaedic Surgeons. © American Academy of Orthopaedic Surgeons.
- 27. Special Considerations • Expose injury. − Explain what you are doing. − Maintain privacy. − Prevent exposure to cold. © American Academy of Orthopaedic Surgeons.
- 28. Special Considerations • Check for medical identification tags. − Wallet − Purse − Necklace to cold. − Bracelet Courtesy of the MedicAlert Foundation®. © 2006, All Rights Reserved. MedicAlert® is a federally registered trademark and service mark. Courtesy of the MedicAlert Foundation®. © 2006, All Rights Reserved. MedicAlert® is a federally registered trademark and service mark.
- 29. SAMPLE History • Helps identify what is wrong with the person • Can indicate what first aid is needed © Jones & Bartlett Learning.
- 30. What to Do Until Medical Help is Available • Recheck a serious illness or injury regularly. • Remaining calm and reassuring the person may be the best treatment you can provide.