First Aid Assessment PDF

First Aid Chapter 2 Initial Assessment Presented by: Ms. Fatima Farhat 1 1  Outline 1. Primary assessment 2. Secondary assessment 2  PRIMARY ASSESSMENT  What is it ? Rapid assessment...

First Aid Chapter 2 Initial Assessment Presented by: Ms. Fatima Farhat 1 1  Outline 1. Primary assessment 2. Secondary assessment 2  PRIMARY ASSESSMENT  What is it ? Rapid assessment Identify anything that can kill Pt Look for anything that’s not right Not just for trauma Not just for unconscious people Easy to remember – work down the body Should be less than 1 min 3  PRIMARY ASSESSMENT Its initial should be under taken to assess the life threatening conditions hat require life-saving first aid. 4 5  RESPONSE Have a look at Pt – big sick or little sick? Approach from feet PAIN – how do we check this? Note how response changes 6  RESPONSE If alerts?  If talking, airway OK - NOTE – obstructed airway?  If talking, breathing OK - NOTE – breathing difficulty?  Assess circulation : Pulse, skin color / moisture / temperature  If NOT Alert? If alone, shout help If in a first aid team 7 AIRWAY 8  AIRWAY (WITH C-SPINE CONSIDERATION) Check C- Spine : Feel down back of neck (tenderness, irregularities) Check jaw: Feel across mandible (fracture obstructing airway?) Check mouth: any obvious obstructions? Remove it Action - Head tilt & Chin lift Check neck: Trachea OK? Swelling? Discoloration? 9  HOW TO ASSESS THE AIRWAY? Assess the patency of the airway and identify the casualty’s airway for signs of obstruction. Recognition of airway obstruction is based on the simple “ look, listen, and feel approach” Look: paradoxical chest and abdominal movements, use of accessory muscles of respiration or cyanosis. Listen: absence of breath sounds, wheezes, stridor, gurgling, snoring. feel: feel for signs of breathing at the mouth and nose (use face or hand) 10  ASSESSMENT OF THE AIRWAY AND C-SPINE  Causes of upper airway: 1.Tongue falling back and blocking the pharynx 2.Vomit, blood and secretions. 3.Foreign body. 4.Tissue swelling caused by allergy, trauma or infection  Causes of lower airway obstruction include: 1.Laryngeal edema (due to burns, inflammation or allergy) 2.Laryngeal spasm (due to foreign body, airway stimulation or secretions/ blood in the airway) 3.Tracheobronchial obstruction (due to aspiration of gastric contents, secretions, pulmonary edema fluid or bronchospasm). 11 BREATHING 12  BREATHING ASSESSMENT Check breathing for 10 secs Also look listen & feel. Check for breathing adequacy, efficacy, and chest movement. 13 CIRCULATION 14  CIRCULATION ASSESSMENT Assessment of the circulation involves assessing the pulse, skin perfusion, and cerebral perfusion. Check abdomen: Bruising? Discoloration? Swelling? Wounds? Feel abdomen: Palpate the four quarters (feel for hardness, watch for tenderness) Feel pelvis : Check for position of iliac crests, Do not ‘spring’ the pelvis!! Feel femurs: Start at the TOP (yes, by the crotch); Firm grip, go down to the knee; Check back for blood 15  DISABILITY/ DYSFUNCTION Assessment of disabilities involves the AVPU scale 16  EXPOSURE If you suspect injuries, have a look! If you can’t see it, you can’t treat it Explore ideas on how to expose your casualty while protecting them from the environment Hypothermia is BAD 17  SECONDARY SURVEY Head To Toe exam Occurs after you have performed your primary survey and appropriate interventions. Question the causality and people around him The causality remain in same position found, at least until you are satisfied that is safe to move into comfortable position. 18 HISTORY 19 HISTORY What happened: Accident, knife, snake bite To find out any medical problem , chronic medication 20  TAKING HISTORY Ask what happened Ask about medication taken Ask about medical history Assess any allergy Assess if have medical warning bracelet. 21  SYMPTOMS Sensation that casualty feels and describe to you Chief complaint ( O-P-Q-R-S-T) CHIEF COMPLAINT of Pain ………………………………… Onset ………………………………………………………… Position: - …………………………………………………… Quality ………………………………………………………… Radiation ……………………………………………………… Severity ………………………………………………………… Time:- A- Duration:………………B Frequency…………………… 22  SIGNS Features or finding from examination of casualty through observing and feeling the casualty: Swelling Bleeding Discoloration Deformity Smell 23  SAMPLE HISTORY  Signs and Symptoms…………………………………………………..  Allergies (Medications, food, etc.) ……………………………..  Medications (Prescribed or Over-the-counter) ……………  Past Medical History………………………………..  Last Meal (Fluid or Solid) 24 25  HEAD TO TOE ASSESSMENT  Head & Neck Check scalp for bleeding or deformity Do not move head Check ears and nose for clear fluid or bloody discharge Mouth for blood or foreign body 26  HEAD TO TOE ASSESSMENT 2. Eyes o Injuries o Ecchymosis o Pupil size o Reaction to light using flash light o Loss of vision o hemorrhage 27  HEAD TO TOE ASSESSMENT 3. Ear o Deformity o Hearing aids o Discharge o Foreign body 28  HEAD TO TOE ASSESSMENT 4. Nose o Deformity o Discharge o Rhinorrhea o Injuries 29  HEAD TO TOE ASSESSMENT 5. mouth: o Ulcer o Bleeding o Hematemesis o Foreign body o Loss of speech 30  HEAD TO TOE ASSESSMENT  Chest and thorax o cuts o Penetration o Deformity o Pain from squeezing or compressing may indicate rib fracture 31  HEAD TO TOE ASSESSMENT Abdomen and flank o Tenderness o Anything protruding or penetrating o Soft o Flat 32  HEAD TO TOE ASSESSMENT  Extremities o Check arms and legs for injury, deformity, or tenderness o Compare two sides of body o Check circulation - pulse, warmth of part, and capillary refill (greater than 2 seconds is abnormal) o Check the radial pulse - in the wrist o Check the pedal pulse - on the ankle or top of the foot for circulation 33  HEAD TO TOE ASSESSMENT  spine and back o Help victim to avoid excessive movement o Check sensation and strength in all extremities by having them press their foot against your hand o Spinal injury - may show paraplegia - paralysis in both legs o The stroke victim is likely to have hemiplegia - hemi (half), plegia (paralysis) o Paralysis of an arm or leg on the same side of the body 34  Make decision What action will be taken 35 36