TPA Grade Sheet

INITIALASSESSMENT *=CRITICALCRITERIA

Assessment TreatmentorFeedback Completed

Tacticalsituation/security/timeonsite* BSIprecautions

MOI/historyofeventsDeterminenumberofpatientsRequesthelpifneeded

AVPU

Chiefcomplaintifconscious

Assessairwayfor510secondsOpenairway(modifiedjawthrust)

* Airwayadjunct(NPA/OPA/ET/Cric)* Reassessairway/BLSasrequired

InspectanteriorchestOccludechestwoundsPosteriorsweep/stopgaps

BloodsweepAssesspulse(radial/carotid)Assessperipheralperfusion(skincolor/temp)Exposeasneeded(environmental)Logroll,ID/TXdownsidewoundsStategeneralimpressionofPtbasedoninj/findings

* Initiatemovementwithintimelimit(timestops)

* ReassessLOC/ABC's/treatments* Reassesschest(IAPP)ifMOI* Needlethoracentesisindicatedyes/no* Considerpainmanagement

INITIALTIME:POINTDEDUCTIONSFROMINITIAL:

Initialmustbecompletedwithin6minutes

Identifyandcontrolmajorbleeding(pack,clamp,dressPRN)

SECURITYHALT

ApplytourniquetPRN(amputation,partialamputationormajorbleeding)

*

*

Manageinjuriesthatcouldcomplicateairwayorbreathing

*

INITIALASSESSMENT

SCENESIZEUP

ASSESSBREATHING

ASSESSAIRWAY(WITHINFIRST5MINS)

ASSESSCIRCULATION

*Direct/provideCspinestabilizationifindicated/CcollarPRN

Determineimmediatelifethreats(massivehemorrhage/airwayobstruction)applystopgaps

Inspectmouthandclear(suction/Heimlich/laryngoscope)

*

5/21/2012

RAPIDASSESSMENT *=CRITICALCRITERIA

Section Assessment TreatmentorFeedback Completed* Movepatientsafely(nofurtherinjury)

Reassess Mentalstatus(AVPU)/allergiesReassessABCsandTXsControlfreeflowinghemorrhageAirway(consideradjunct)(reassessplacementPRN)Inspect/palpateheadAssessthepupils(PERRLA)

Neck AssessforJVDAssessfortrachealdeviationPalpateCspine/applyCcollarifMOI

* TreatallinjuriesReassesspriorTXs/reinforcePRN

Anterior * Inspect/auscultatex3bilateralChest Auscultateheart

* Percussx3bilateralifMOIPalpate/IDallinjuries/improvestopgapsInspecttheabdomenforobviousinjury

Abdomen PalpateallquadrantsPelvis Assessthepelvis

IDallpelvicinjuries/improvestopgapsExtremities I&Plegs(Hem/FX) I&Pshoulders/armsLogroll * MaintainC/LspinecontrolLspine * Palpate/inspectLspine/TXinjuriesAssess/TX

Posterior

Reassess * CheckplacementofETtubeAirway ReassessalltreatmentsReassessCirculation

Vitals ObtainbaselineVS/assessneedforfluids* ObtainperipheralIVaccess* Reconsiderpainmanagement

Reassess ReassessABCs/TXTourniquet * Proximate/convert/pressuredressing

Splintallfractures(tractionifneeded)

Vitals * Assessandaddressvitalsigns

PriortoIV EndofClinicLOC

B/P

PULSE *

RESP *SkinTemp

COMBINEDINITIALANDRAPIDTIME:POINTDEDUCTIONSFROMRAPID:

Initialandrapidcombinedmustbecompletewithin29minutes

VITALSIGNS

Splints *

Airway *

ID/treatsallinjuries/improvesstopgaps

* HeadtoFoot

IV

5/21/2012

SUBTASKS *=CRITICALCRITERIA

PrepequipmentIDsitePrepsitew/antiseptic(Mech/Chem)

* Insertcatheter* Connecttubing

CheckpatencySecuretubing

* IDlandmarksPrepsitewithantiseptic(Mech/Chem)SelectappropriatesizecathInsertcatheterovertheribRemoveneedle(leavecatheter)

* Preoxygenate(2mins)Prepareequipment

* Inserttube* Inflatecuff* Assessplacement* Assessrespiration

InsertbiteblockSecuretube

DEDUCTIONSFROMINITIALASSESSMENT:DEDUCTIONSFROMRAPIDASSESSMENT:

FINALSCORE:

TOTALPOINTS=150(50FORINITIALAND100FORRAPID)112.5=75%38POINTSLOSTIS