# Rapid Trauma Assessment



## mcvey7218

Another question...I have gotten totally confused about the steps of the Rapid Trauma Assessment vs. Focused Assessment vs. Detailed Physical Exam.  Can anyone give me any pointers or hints that will help me to remember exactly what it is that I am supposed to be doing and at which time I am to be doing it?  Also, our text says that in the rapid trauma assessment, we cover DCAP-BTLS, which I understand, and that we are to assess the face, ears, eyes, nose, and mouth during the detailed physical exam, once the patient is in the rig and enroute to the hospital.  However, from what I understand, the face, ears, eyes, nose, and mouth are part of the rapid trauma assessment during the NR exam.  So, during my practicals, which method do I use?


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## Ridryder911

Look at the NR exam skill sheet(s) and it will go in sequence and order you exam. The initial or now back to being called primary survey includes the face for such as LOC, oral cavity for airway acceptance and checking quickly for exsanguinating hemorrhaging. 

R/r 911


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## bstone

This website really helped me when I did my advanced level trauma patient assessment with the NREMT 2 weeks ago:
http://www.everything2.com/index.pl?node_id=1450809&displaytype=printable&lastnode_id=1450809


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## Airwaygoddess

So here we go, Rapid trauma assessment is for trauma and if you have a patient that is unconsciousness unresponsive.  This assessment is first and foremost check the Airway-Breathing-Circulation, correct those LIFE THREATING things first.  Then the rest is a quick body system check, what is working, whats not and what needs to be corrected /fixed with interventions.
  Focused is when the patient complains of what is hurting or bothering them, the reason why they called the ambulance, i.e. my chest hurts, I can't catch my breath, I broke my leg, etc.  after again checking on the ABC'S first and correcting those LIFE THREATING problems you would then FOCUS on that patient's chief complaint and check and do an assesment on the part that the patient complains of.  Please be sure to get a good SAMPLE and don't get pulled into tunnel vision,  sometimes things can be missed by not looking at the whole big pictureof your patient
  Detailed is when you have your patient in the ambulance and you would recheck you patient as it says in more detail, if time allows and there are no apparent life threats going on at the same time.  Remember, ABC"s come first and foremost and like Rid suggested, read over your skills sheets and ask questions.  Hope this helps!


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## Airwaygoddess

So here we go, Rapid trauma assessment is for trauma and if you have a patient that is unconsciousness unresponsive.  This assessment is first and foremost check the Airway-Breathing-Circulation, correct those LIFE THREATING things first.  Then the rest is a quick body system check, what is working, what's not and what needs to be corrected /fixed with interventions.
  Focused is when the patient complains of what is hurting or bothering them, the reason why they called the ambulance, i.e. my chest hurts, I can't catch my breath, I broke my leg, etc.  after again checking on the ABC'S first and correcting those LIFE THREATING problems you would then FOCUS on that patient's chief complaint and check and do an assesment on the part that the patient complains of.  Please be sure to get a good SAMPLE and don't get pulled into tunnel vision,  sometimes things can be missed by not looking at the whole big picture of your patient
  Detailed is when you have your patient in the ambulance and you would recheck you patient as it says in more detail, if time allows and there are no apparent life threats going on at the same time.  Remember, ABC"s come first and foremost and like Rid suggested, read over your skills sheets and ask questions.  Hope this helps!


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## Airwaygoddess

WHOOPS!  Double post, sorry about that folks! :wacko:


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## Mercy4Angels

love the double posts ! i get to read them twice, LOL


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## DezertRanger-EMT

correct me if i am wrong, but don't unconscious patients all get flip and strip which falls under physical detailed exam?

sorry for bringing up an old post


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## bstone

DezertRanger-EMT said:


> correct me if i am wrong, but don't unconscious patients all get flip and strip which falls under physical detailed exam?
> 
> sorry for bringing up an old post



It's only 3.5 years old, but why not! LOL!

When you flip and strip a patient happens during the detailed physical exam. Initially you are just assessing the basics, but then you flip (holding c-spine, at the call of the guy holding the head), strip and check.


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## DezertRanger-EMT

bstone said:


> It's only 3.5 years old, but why not! LOL!
> 
> When you flip and strip a patient happens during the detailed physical exam. Initially you are just assessing the basics, but then you flip (holding c-spine, at the call of the guy holding the head), strip and check.



haha sorry trying to keep things fresh it has been a wile I'm so busy with work and school to be able to study i need to read the book over again and buy another work book for it.

yeah it basically is the rapid trauma without cutting close away


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## zmedic

I'm going to disagree. You roll (flip) the patient during your rapid trauma assessment while on scene, checking for bleeding and spinal tenderness/deformity and then roll the patient onto the backboard. The detailed survey happens later, after you've addressed any injuries you've found and you are on the way to the hospital to make sure that you haven't missed anything. I'd say it is most appropriate to strip at this point, when you are in the climate controlled ambulance. If you've already exposed fractures and other sites of injury on scene, full exposure isn't needed until you are in the rig.


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## bstone

Ya know what, you're right. You do flip onto the back during the initial assessment. You can also board and collar them, while flipping.


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## DezertRanger-EMT

zmedic said:


> I'm going to disagree. You roll (flip) the patient during your rapid trauma assessment while on scene, checking for bleeding and spinal tenderness/deformity and then roll the patient onto the backboard. The detailed survey happens later, after you've addressed any injuries you've found and you are on the way to the hospital to make sure that you haven't missed anything. I'd say it is most appropriate to strip at this point, when you are in the climate controlled ambulance. If you've already exposed fractures and other sites of injury on scene, full exposure isn't needed until you are in the rig.



i do this with my rapid trauma assessment still, I'm just meaning its the same assessment you take just later in the ambulance and you cut  the close away, but i thanks for the details.


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## CAOX3

What the hells a rapid trauma assessment, sorry all I know is patient assessment.  

I dont understand the need for focused, rapid, medical, trauma, yada, yada, yada assessment.....


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## bstone

http://www.youtube.com/watch?v=N286qbTCVUQ


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## DezertRanger-EMT

Rapid trauma is checking the head neck torso palpating all 4 quadrants, checking the legs and arms and assesing pms pulse motor sensation and also checking the back as you log role them.


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## Veneficus

CAOX3 said:


> What the hells a rapid trauma assessment, sorry all I know is patient assessment.
> 
> I dont understand the need for focused, rapid, medical, trauma, yada, yada, yada assessment.....



It was a poorly thought out way to break the complexity of assessment in a linear way that could be remembered by students that just creates confusion.

Those people over at curriculum design and NREMT are not always the brightest of crayons.


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## DezertRanger-EMT

Veneficus said:


> It was a poorly thought out way to break the complexity of assessment in a linear way that could be remembered by students that just creates confusion.
> 
> Those people over at curriculum design and NREMT are not always the brightest of crayons.



Especially when your tought one way in class and told to answer another way on the nremt test


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## zmedic

I like breaking the assessment apart into a rapid and detailed. It prevents people from spending their first ten minutes on scene checking things like cranial nerves. The rapid assessment tells you what life threats you need to deal with in the next five minutes and what equipment you need to get or call for (will this be a spinal patient? ONe that needs splinting? etc). Then the detailed is gathering all kinds of info that is nice for the hospital to have but won't really change what you need to do to get the person into the ambulance. 

I think it's easy as someone with more training like a medic to say that the rules and systems are artificial and dumbed down, but if you look at who is coming out of EMT classes with minimally passing scores they really aren't in a position to decide on their own what to cut out of a full complex assessment.


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## Veneficus

zmedic said:


> I like breaking the assessment apart into a rapid and detailed. It prevents people from spending their first ten minutes on scene checking things like cranial nerves. The rapid assessment tells you what life threats you need to deal with in the next five minutes and what equipment you need to get or call for (will this be a spinal patient? ONe that needs splinting? etc). Then the detailed is gathering all kinds of info that is nice for the hospital to have but won't really change what you need to do to get the person into the ambulance.
> 
> I think it's easy as someone with more training like a medic to say that the rules and systems are artificial and dumbed down, but if you look at who is coming out of EMT classes with minimally passing scores they really aren't in a position to decide on their own what to cut out of a full complex assessment.



my problem is actually that once the linear breakdown is taught, there should be some time putting it together rather than testing it in the broken down form. 

What ends up happening is the minimally qualified get out on the street where they start to put things together without the benefit of formal guidance in many cases, and end up deciding for themselves what is important or not via trial and error. As you said, they are not in a position to decide what not to cut out on their own. But they are doing it all the same.


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