Trauma Assessment

Station 3A
On Scene
1) Scene safety/BSI for myself and my crew
2) I am going to ask my partner hold C-spine stabilization
3) Assess responsiveness of the patient using the AVPU scale
 Sir/ma'am are you ok? If there is no response to verbal stimuli, I would check for painful
stimuli. If there is no response to both, my patient is unresponsive.
Airway: Open the airway, clear the airway, maintain the airway
4) Using the modified jaw thrust maneuver I will open and look in the airway or any obstructions
 Is there any blood, vomit, teeth, swelling or other obstructions in the airway?
- If yes, I will suction away for 10-15 seconds. Is the airway now clear/patent?
5) I am going to measure and insert an OPA. I will measure from the corner of the mouth to the tip
of the ear, inserting the OPA bevel side up until resistance is met with the soft palate, rotate it
180 degrees and insert until the flange is flush with the lips
Breathing
6) I am going to expose, auscultate and palpate the chest for any life-threatening injuries
 Is there any paradoxical motion/flail chest? à apply manual stabilization of the flail
segment
 Are there any sucking chest wounds? à apply an occlusive dressing or chest seal
7) I am going to assess the rate, rhythm and quality of the breathing, and listen to lungs sounds
 Is the breathing shallow, slow or diminished? Are the lung sounds clear?
8) I will apply a non-rebreather mask at 15 L/min of high flow, high concentration oxygen. I will
listen to lung sounds in 2 places to assure adequate ventilation
Circulation
9) I will check pulses at the carotid and radial arteries looking for the rate, rhythm and quality
10) I will check skin color, temperature and condition at the chest wall
11) With gloved hands, I will assess for gross hemorrhaging and check for pulses at each extremity
 From head to toe do a blood sweep by clam shelling the underside of the patient and
check the major voids (behind neck, small of back, knees and ankles) for any major
bleeding
- If there is a bleed apply direct pressure à if direct pressure does not stop the
bleeding, apply a tourniquet or pressure bandage
 Palpate a pulse at each extremity and mark with an X where the pulse is present
Decision
12) This is a Priority 1 patient and requires rapid transport to the nearest trauma hospital with an
ALS intercept

Pre-truck
13) I am going to perform a full body assessment looking for any DCAP BTLS
 Deformities, Contusions, Abrasions, Penetrations/Punctures, Burns, Tenderness,
Lacerations, Swelling
14) I will inspect and palpate head and face looking for any DCAP BTLS
 Looking if the pupils are PERRL, check for raccoon eyes, Battle’s signs or any fluids in the
ears and nostrils (blood or CSF)
15) I will inspect and palpate the neck for any step-offs, JVD or tracheal deviation
 I will measure and apply an appropriately sized cervical collar
16) I will inspect and palpate the chest looking for DCAP BTLS
 I will palpate the sternum and ribs and make sure any interventions made remain in
place (occlusive dressing or stabilization of flail chest)
 I will auscultate lung sounds in 6-8 places
17) I will inspect and palpate the abdomen looking for DCAP BTLS
 I will divide the abdomen into 4 quadrants looking for rebound tenderness, firmness,
rigidity, distention, guarding or pulsating masses
18) I will assess the pelvis looking for DCAP BTLS
 I will feel for pelvic stability by pushing in and down feeling for any crepitus
 I will assess the genitalia looking for any bleeding, incontinence, priapism in males or
discharge in females
19) I will assess the lower extremities looking for DCAP BTLS and check the pedal pulses bilaterally
 If my patient is conscious, I will assess for sensation and motor function
20) I will assess the upper extremities looking for DCAP BTLS and check the radial pulses bilaterally
 If my patient is conscious, I will assess for sensation and motor function
21) Using a 4-person log roll, at the head person’s count, I will log roll the patient towards me
22) I will assess the posterior thorax looking for DCAP BTLS
 I will auscultate lung sounds in 6-8 places
23) I will assess the entire posterior side of the patient looking for DCAP BTLS or crepitus
 I will look for any fecal incontinence or bleeding
24) Using a 4-person log roll, at the head person’s count, I will log roll the patient on to a long board
and secure them appropriately
25) I will obtain set of baseline vital signs checking for HR, RR, BP, O2 Sat, CTC, BGL
26) I will obtain a SAMPLE history if available
27) I will manage any secondary injuries I have found at this time
 Name the secondary injuries and a brief description of treatment
28) I will do a detailed physical exam and perform ongoing assessment
29) I will re-assess vital signs every 5 minutes during transport