Patient Assessment 101
First Aid skills are very important to have in any extreme sports or activity which has an increased chance of injury. You should take the time to read the following sections to assure you have some basic knowledge about what you can and should do if you are confronted with a First Aid situation.
Their are a couple of ground rules when it comes to first aid and emergency situations.
Remain Calm and in Control.
Do nothing to add further tension to the situation. The victim and the events will already cause a tense situation do nothing to add to the tension but try to calm it down instead.
Put in motion the Emergency Action Steps: Check-Call-Care.
Check the scene for safety.
Check the scene for safety; find the source of the injury if possible, and only enter the scene if the scene is safe. Make sure the danger has passed and the surrounding are safe. There is no use of becoming a victim yourself.
Protect yourself (BSI).
BSI stands for Body Substance Isolation. this means to wear rubber or latex gloves, eye protection, and a face mask if necessary. Diseases can be transmitted via many different routes - however the 2 most common ways to contract a disease or bacteria from an injured patient are skin to fluid contact, and airborne contact. Assess the situation and take proper BSI precautions before entering the scene.
The Victim(s) for consciousness and life-threatening conditions.
Check the patient for consciousness by simply tapping them on the shoulder and shouting "Are you Okay?". If they can answer your question then that tells you that the victim is conscious, breathing and that the heart is working. Check the victim for life-threatening injuries and conditions (severe bleeding, trouble breathing, shock, etc.)
If the victim is unable to respond, is unconscious, or has a life-threatening condition, move onto the next step (call).
Send for Emergency Help (Dial 9-1-1)
If you are with multiple people (usually bystanders), assign one person to go call 9-1-1 or the local emergency phone number. If you have a mobile phone or another way of reaching the outside world, use it. Explain calmly and clearly the location of the incident and the condition of the victim(s). Do not hang up until medical personnel arrive or the operator tells you that it is okay to hang up.
We've now assessed that the patient is unconscious or has a life-threatening condition. The first portion of caring for a patient, is to assess three (3) things: Airway, Breathing & Circulation. This initial assessment lets us know the basics and can then help us to determine our next course of action.
Make sure that the victim has an open airway. An airway includes the nose, mouth, throat, lungs, and diaphragm. If the patient does not have a traumatic injury (possible spinal injury), you can open the airway by tilting the head back - with the chin facing up. This 'pops' the tongue into a position where it is not falling back into the throat. The tongue is the most common form of airway obstruction. Do NOT perform a head-tilt / chin-lift maneuver on a patient with possible spinal injuries. In those instances, you must do a Jaw Thrust maneuver. The airway is the most important thing for a patient to have. Without a proper airway, the person cannot breathe!
Make sure that the victim is breathing by putting your ear over the patient's nose and mouth and looking at their chest. Look at the chest to see if it is rising, listen and feel with your ear to hear or feel breathing coming from the patient's nose and mouth. Do this for about 5 - 10 seconds.
Next, we see if the patient's airway is in fact clear by breathing for the patient. We do this by giving 2 slow breaths, making sure that the chest rises for each breath. Assuming the chest rises, we have a clear airway.
Make sure that the patient has perfusion (a pulse). Check for a pulse and visual signs such as complexion and blinking of the eyes. For adults (ages >8) and children (ages 1+), check for a pulse on the neck, on top of the carotid artery. For infants (<12 months), check for a pulse on the brachial artery (on the arm, between the elbow and shoulder). All that you are really looking for is whether or not they have a pulse (yes / no).
At this point, we have established the basics:
- Whether or not the patient is conscious or unconscious.
- Whether or not the patient has a life-threatening condition.
- If the patient has an airway.
- If the patient is breathing.
- If the patient has a pulse.
From this point forward, we can make decisions about how to proceed next. The first step would be to address Life-Threatening Conditions first.
To learn more about how to assess and treat for injuries and illnesses, take a course! By becoming certified, you will not only have a much larger base of knowledge and skills, but you will also be joining millions of fellow first aid providers across the country!