FLOWCHART FOR PATIENT CARE

SIZE UP THE SCENE

1. Ensure that the scene is safe
UNSAFE 2. Wear appropriate PPE
3. Establish the number of patients
4. Assess if there is a need for additional
resources such as back-up responders

• Move the patient

to a safer place SAFE
• Control any hazard

QUICK
TRAUMA INITIAL MEDICAL
ASSESSMENT

ASSESS:
• MECHANISM OF INJURY
• LEVEL OF CONSCIOUSNESS
• AIRWAY
• BREATHING
• CIRCULATION
• EYE RESPONSE
• Please see • Please see
algorithm for DECIDE IF algorithm for
Trauma Patients • TRAUMA Medical Patients
• MEDICAL
• BOTH

Vital Signs Parameters

13-15 9 - 12 3-8
 TRAUMA
Patient

Assess MOI

Suspected YES • Ensure safety taking

spinal cord note to minimize
injury? movement of the
patient

Assess Mental Status

Assess CLOSED • PERFORM JAW-THRUST

MANEUVER
AIRWAY

OPEN

Assess INADEQUATE • Provide Oxygen

• Provide ventilation via
BREATHING ambubagging

ADEQUATE

Assess NO PULSE
CIRCULATION START CPR

WITH PULSE

Assess BLEEDING CONTROL

BLEEDING BLEEDING

NONE
TRANSPORT TO
Focused history and
NEAREST FACILITY
Assess SKIN, EYES, GCS Physical examination
Can be done while
providing treatment or
during transportation
 FOCUSED HISTORY AND
PHYSICAL EXAMINATION
CAN BE DONE WHILE PROVIDING TREATMENT
OR DURING TRANSPORTATION

ALERT/ UNCONSCIOUS/
UNINJURED OBVIOUS INJURY
RECONSIDER
THE MOI

VITAL SIGNS:
NO SIGNIFICANT MOI Temperature, BP, pulse, SIGNIFICANT MOI
SINGLE INJURY respiration, O2 sat MULTIPLE INJURIES
ALERT AWAKE PATIENT GCS 13 AND BELOW
EYES, SKINS

LEVEL OF CONSCIOUSNESS
PERFORM FOCUSED CONTINUE
HISTORY AND PHYSICAL History:
STABILIZATION
EXAM • Signs and symptoms
• Allergies
• Medications
• Past medical history and
maintenance meds CONTINUE
TAKE BASELINE VITAL REASSESSMENT OF
SIGNS MENTAL STATUS

PERFORM RAPID
RECORD HISTORY TRAUMA ASSESSMENT

Perform needed
detailed PE (see CONSIDER ADVANCE
algorithm for detailed LIFE SUPPORT
PE)

TAKE VITAL SIGNS SND

CONTINUE ON-GOING
PROVIDE RECORD QUICK
ASSESSMENT AND
APPROPRIATE FIRST HISTORY
MONITOR VITAL
AID
SIGNS EVERY 5 MINS.

PROVIDE
APPROPRIATE FIRST
COMMUNICATE AND DOCUMENT AID

TRANSPORT TO
NEAREST FACILITY
 MEDICAL
Patient

Assess Mental Status

Assess CLOSED • PERFORM HEAD TILT

CHIN LIFT
AIRWAY

OPEN

Assess INADEQUATE • Provide Oxygen

• Provide ventilation via
BREATHING ambubagging

ADEQUATE

Assess NO PULSE
CIRCULATION START CPR

WITH PULSE

Assess BLEEDING CONTROL

BLEEDING BLEEDING

NONE
TRANSPORT TO
NEAREST FACILITY
Assess SKIN, EYES, GCS

Focused history and

Physical examination
Can be done while
providing treatment or
during transportation
 FOCUSED HISTORY AND
PHYSICAL EXAMINATION
CAN BE DONE WHILE PROVIDING TREATMENT
OR DURING TRANSPORTATION

ALTERED/
ALERT CONSIDER GCS 13 AND BELOW
MENTAL
STATUS

VITAL SIGNS:
Temperature, BP, pulse,
RESPONSIVE respiration, O2 sat UNRESPONSIVE

EYES, SKINS

LEVEL OF CONSCIOUSNESS
ASSESS CHIEF
CONTINUE
COMPLAINT, SIGNS AND History:
• Signs and symptoms STABILIZATION
SYMPTOMS
• Allergies
• Medications
• Past medical history and
maintenance meds
CONTINUE
TAKE BASELINE VITAL REASSESSMENT OF
SIGNS MENTAL STATUS

PERFORM RAPID
RECORD HISTORY TRAUMA ASSESSMENT

Perform needed
detailed PE (see CONSIDER ADVANCE
algorithm for detailed LIFE SUPPORT
PE)

TAKE VITAL SIGNS SND

PROVIDE RECORD QUICK
APPROPRIATE FIRST HISTORY
CONTINUE ON-GOING
AID
ASSESSMENT AND
MONITOR VITAL
PROVIDE
SIGNS EVERY 5 MINS.
APPROPRIATE FIRST
AID
TRANSPORT TO
NEAREST FACILITY

COMMUNICATE AND DOCUMENT

 PREGNANT
PATIENT

• Ask if how many week of gestation

• Ask for the prenatal record
• Ask if first or multiple pregnancy CONTINUE ON-GOING
ASSESSMENT AND
MONITOR VITAL SIGNS
EVERY 5 MINS.

ASSESS CHIEF
COMPLAINT,
NO Any danger YES TRANSPORT TO
signs of
SIGNS AND NEAREST FACILITY
pregnancy
SYMPTOMS
Danger signs: COMMUNICATE
• Bleeding AND DOCUMENT
• Ruptured bag of water
• Elevated blood pressure
YES • Seizure
IMMINENT
• Active contractions
DELIVERY?
every 2-3 mins
previously underwent
Cesarean Section
NO
Imminent Delivery:
• Frequent contractions
Record history and occurring every 2-3 mins
vital signs • Crowning head of the
baby at the vagina
• Sensation of the mother
to move her bowel
• Ruptured bag of water
with above sensations

Focused history and

Physical examination
Can be done while
providing treatment or
during transportation
• PREPARE FOR DELIVERY
COORDINATE WITH RHU
NURSE/MIDWIFE WNILE
MONITORING THE
PATIENT AND PRPARING
FOR DELIVERY

TRANSPORT TO
RHU/CLINIC
 PREPARATION FOR
DELIVERY

PREPARE NEEDED
WEAR PPE
MATERIALS
ESPECIALLY GLOVES
*recommended for the
PREFERRABLY
ambulance to have an OB
STERILE
bag at hand

Assist the mother into a

suitable position, lying
down on the bed or floor

Place a piece of plastic

over the clean sheets or
towels to protect the bed
or floor

Prepare for delivery of the baby:

1. Support the head
2. Remove cord around the neck
3. Support the body
4. Position for drainage
5. DO NOT attempt to cut the cord

INITIATE NEWBORN CARE DELIVER THE PLACENTA

Monitor Vital signs

• Immediate drying Continue monitor for bleeding
• Skin to skin contact Check if uterus is contracting
• Non-separation of the mother
• DO NOT ATTEMPT TO CUT THE
CORD unless necessary and
with STERILE tools
• Keep the newborn warm
CONTINUE ON-GOING
ASSESSMENT AND
MONITOR VITAL SIGNS
EVERY 5 MINS.

TRANSPORT TO COMMUNICATE
NEAREST FACILITY AND DOCUMENT
 DETAILED ASSESSMENT
CAN BE DONE WHILE PROVIDING TREATMENT
OR DURING TRANSPORTATION

ALERT/
UNINJURED RECONSIDER DECLINING
MENTAL
STATUS

RESPONSIVE UNRESPONSIVE

POSITION AN
UNCONSCIOUS PATIENT

Perform FOCUSED PHYSICAL

EXAM BASED ON THE Assess DCAPBTLS
PATIENT’S CHIEF
COMPLAINT AND INQUIRIY

Assess EARS FOR FLUID

ASSESS Assess FACE FOR

VITAL SIGNS: ASSYMETRY
Temperature, BP, pulse,
respiration, O2 sat
Assess EYES,
EYES, SKINS NOSE,MOUTH

LEVEL OF
CONSCIOUSNESS Assess CHEST for
PARADOXICAL
History: MOVEMENT, DCAP BTLS
• Signs and symptoms
• Allergies
• Medications
• Past medical history and Assess ABDOMEN FOR
maintenance meds DCAP BTLS

Assess PELVIS FOR

DCAP BTLS

Assess EXTREMITIES
FOR DCAP BTLS,
ASSYMETRY

REASSESS VITAL SIGNS

EVERY 5 MINS