http://www.jblearning.com/catalog/9780763758769/
I'm wondering if any of you are familiar with this publication and can offer any opinions about it. Or if you're not directly familiar with it, what do you think about it after reviewing the description and sample cases. Is it worth buying? (I can get it on Amazon for ~$40.)
The description says it's for both experienced and inexperienced providers. I'm in the latter category. As such, I'm not necessarily looking to improve my
speed at this point, but rather my
quality.
I'm sure it can help you somewhat.
In the meantime, just do what I do:
As you approach the pt - as you walk in the room, approach them on the street, whatever, take a good look at them. Are they sitting comfortably, standing steadily, are they doubled over in pain, are they relaxed, do they look terrified? Intorduce yourself. As you ask them how they are, note their reaction. Are they quick to respond, does it take them a few moments to reply, do they have to catch their breath between words, do they have accessory muscle use, can you hear rales, wheezing, or coughing from across the room? Can they converse with you, or do they appear altered? Anxious/combative or lethargic?
Walk up, kneel beside them, and check their pulse while you get their chief complaint. Before they even begin to tell you anything, you have their skin CTC, and their pulse. You're not taking an actual number yet, but a quick check to see if it's regular or not, is it fast or slow, weak or bounding.
You can tell a lot in under 30 seconds before you even get to their chief complaint. If they're SOB and can't complete a sentence, they're clutching their chest, if they're pale and sweaty, if they're profoundly weak and unsteady, if they're altered, to include combativeness/irritability or lethargy, you need to get to work. The most telling sign of perfusion is mental status. If the brain isn't getting enough O2 or glucose, for whatever reason, they'll become altered. You need to get to work. At the BLS level, why they're altered, why they're not breathing well, why they have orthostatic changes, may be above your head. You need to intervene a/p your scope, package, and be ready to deliver the pt to the medics on a chair, LSB, or Reeves, whichever is appropriate.
Get their chief complaint. Off the C/C and your findings in that first 30 seconds, you may choose to do a stroke assessment, check for orthostatic V/S changes, a temp, their BGL, etc. I'm not mentioning ALS diagnostics because your training says BLS; I'm trying to keep the assesment at that level. You're always going to get general vitals, lung sounds (do this before BP, pulse rate, etc.). A good number of our treatments depend on the pt's L/S. If the pt had a fall not attributed to tripping, or if the pt had a syncopal episode or memory gap before crashing their vehicle, strongly consider addressing their medical needs before addressing that broken arm, any lacerations that aren't bleeding copiously (that would be an apparent lifre threat), initiating spinal motion restriction if appropriate at first, of course.
Just follow that template, position the properly, get O2 and bleeding control if necessary (the need for CPR would be obvious), package right after that, and you can't go wrong.
If you have any questions regarding the above, let me know.