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Chapter 4
Finding Out What’s Wrong
Checking the Victim• Victim assessment• Sequence of actions that helps determine
what is wrong • Ensures safe and appropriate first aid• Goals are:
• Detect life-threatening conditions rapidly• Determine other problems needing care• Determine if the victim needs medical
care
Scene Size-Up
• Determines the safety of the scene
• Cause of injury or nature of illness
• Number of victims
• If scene appears hazardous, do not enter!
Initial Check (1 of 5)
• Determines if there are life-threatening problems requiring quick care.
• Involves checking the victim’s responsiveness, opening the airway, checking for breathing, and checking for severe bleeding.
Initial Check (2 of 5)
• Determine if the victim is responsive.
Initial Check (3 of 5)
• Ensure that the victim’s airway is open.
Initial Check (4 of 5)
• Determine if the victim is breathing.
Initial Check (5 of 5)
• Check for any obvious, severe bleeding.
General Impression of Victim
• Also known as first impression, look test, or a gut reaction
• Determine whether the victim is injured or ill.
Check Responsiveness
• Victim can be responsive or unresponsive
• AVPU scale
• A – alert
• V – Responsive to verbal stimulus
• P – Responsive only to painful stimulus
• U – Unresponsive to any stimulus
Open Airway
• Airway must be open for breathing.
• Use the head tilt-chin lift method to open the airway.
Check for Breathing
• Check for breathing sounds that might indicate a problem.
• Check for breathing in an unresponsive victim while opening the airway.
• Look, listen, and feel.
Check for Severe Bleeding
• Look over the victim’s entire body for blood.
• Apply direct pressure and a sterile dressing.
• Avoid contact with the victim’s blood.
Skin Condition
• Skin temperature
• Color
• Reflects circulation
• Condition
Expose the Injury
• Clothing may have to be removed to check for injury and to provide first aid.
• Explain what you intend to do and why first.
Physical Exam
• Goal is to immediately identify any potentially life-threatening illness or injury.
• Most victims will not require a complete head-to-toe type of physical exam.
Signs and Symptoms• Signs
• Victim’s conditions you can see, feel, hear, or smell.
• Symptoms
• Things the victim feels and is able to describe; known as the chief complaint.
DOTS
• D = Deformity
• O = Open wounds
• T = Tenderness
• S= Swelling
Conducting a Physical Exam (1 of 7)
• Head: check for DOTS
Conducting a Physical Exam (2 of 7)
• Neck: check for DOTS
Conducting a Physical Exam (3 of 7)
• Chest: check for DOTS
Conducting a Physical Exam (4 of 7)
• Abdomen: check for DOTS
Conducting a Physical Exam (5 of 7)
• Pelvis: check for DOTS
Conducting a Physical Exam (6 of 7)
• Extremities: check both arms and legs for DOTS
Conducting a Physical Exam (7 of 7)
• Back: if no spinal injury is suspected, turn the victim on his or her side and check for DOTS
SAMPLE History
• S = Symptoms
• A = Allergies
• M = Medications
• P = Past medical history
• L = Last oral intake
• E = Events leading up to the illness or injury
Medical Identification Tags
• Look for a medical identification tag or a medical information card.
• Beneficial in identifying allergies, medications, or medical history
Putting It All Together• If victim requires medical care, pass this
information on:• Victim’s chief complaint• Responsiveness• Initial check• Physical exam findings• SAMPLE history• Any first aid that has been provided
Triage
• Process of prioritizing multiple victims
• Immediate care
• Urgent care
• Delayed care
• Dead
Advantages of the Left-Side Position
• Also called recovery position• Has several advantages:
• Keeps airway open• Delays vomiting• Delays poison’s effects• Relieves pressure on a
pregnant woman’s vena cava
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