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Celtictigeress

Celtictigeress

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okay I have trauma assessment come manana... anywho

for the determines cheif complaint/life threats...I strip first right??? and THEN go into abcs? or do I go through ABCS THEN expose??? its for registry any help will be GREATLY appreciated
 
I was told by my instructor to strip and expose for life threats...

then ABCS an treat

Im told by another that I treat the ABCs THEN expose.. but how can you determine the life threats if they arent exposed?
 
In my class we were taught in this order-
BSI- Scene Safety
Determine MOI
Number of patients
Request help if necessary
consider c-spine
Generalize first impression of patient (is he FUBAR??)
Determine LOC
Determine Cheif Complaint/life threats (IE- environmental dangers and what is pt whining about??)
Then do ABCs - I believe when doing your chest examination you would strip to see if there is anything affecting his airway at this time.
Based on your ABC you need to make a transport decision - stay and play or load and go?
 
Celtictigeress said:
I was told by my instructor to strip and expose for life threats...

then ABCS an treat

Im told by another that I treat the ABCs THEN expose.. but how can you determine the life threats if they arent exposed?
Click to expand...

And as fast as the initial assessment goes your not going to be worried about stripping him. Your life threats are basically environmental such as lightning storm, riots, dangerous animals, etc. And you need to ask your patient "What is bothering you?" When you assess your ABCs your going to have to strip anyway to do a chest examination to see if there is paradoxial motion and possible chest injury.

-CP
 
thats what I thought...

I was taught that same order, but then my instructor told me "when you determine chief complaints/life threats of an unconcious go ahead and strip.. your going to have to anyway so this is a good time to expose" he told me the whole exposing is to make sure that you can see, that the board is nitpicky..and to verbalize verbalize verbalize...

when we had the auto accident here funny thing is I did it fine but I didnt have the pressure of "pass or fail"
 
Heres how Id do it
BSI
Look around the scene as you approach to gather clues of MOI (IE car is smashed, human sized hole in windshield, pt is lying about 10ft from vehicle)
While approaching the scene look for any other patients, you and your partner go around seperate sides of vehicle and look inside vehicle doing a quick but safe scan.
If it looks like and ALS call or youve got more pts than your crew can handle, then radio for additional units.
Take a quick moment to see how bad your pt. is. (Blood gushing out of thigh is NOT a good sign!)
Determine LOC by identifying yourself and asking the pt his name if he doesnt respond do AVPU (Alert, Verbal, Pain, Unconscious)
Then ask, Name, what hurts the most???
Then assess airway, if hes talking in complete sentences and calm he's got a open airway, if not, time to do something. Remember A-B-C
Airway - is his airway open?
Breathing - are is respirations within normal range? Good chest rise?
Circulation - does he have a good strong steady pulse within normal ranges.

If the ABCs warrant it strip the chest area to expose it and any problems with the chest rise (sucking chest wound, uneven chest rise, no chest rise)

Remember when going in for skill check-offs go in confident and calm. Nerves can ruin an otherwise good patient asessment.

-CP
 
Thanks

Im calm I spent an hour on the phone with a friend of mine from on here... we talked ran through it several times.. I*m taking a breather

I swear if I dont get it this time, the guy will have to reswallow his nuts..... or I will shove my foot so far up his a** he has my toes for his teeth..
But it isnt that bad...Ima take it easy tonight I lifted weights to get rid of the frustration...and anexity
 
If ya follow the sheets like I told ya to you should pass, if not let me know and I will draft a highly opinionated and baseless letter to the state.
 
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