Friday, March 11, 2016

365 True Things: 348/Medical

Tomorrow's Search & Rescue training covers patient assessment. We were advised to review our SAMPLE and mind our PQRST's.

I always have trouble remembering the acronyms and mnemonics. Perhaps because I only have occasion to use them once or twice a year, during these trainings.

I've just found my notebook with ALL my medical (Wilderness First Responder) notes, including advanced airway management, bloodborne pathogens, lifting and moving, pediatric assessment, extrication and patient packaging, spinal injuries, diabetic emergencies, CPR, and . . . okay, here we go:

A. Scene size-up, a.k.a. PENMAN: PPE (personal protective equipment), Environmental safety and considerations, Number of patients, MOI (mechanism of injury) or nature of illness, Additional resources/special equipment needed, and Need for c-spine precautions.

B. Primary survey, a.k.a. ABCs (assess and manage): Airway, Breathing, Circulation, Disability (mentation—and another mnemonic: AVPU, Alert, [responds to] Verbal stimulus, [responds to] Painful [stimulus], Unresponsive), and Expose, examine, and protect from the environment.

C. Baseline medical, a.k.a. SAMPLE history: Signs (observable) and symptoms (described by patient), Allergies, Medications, Past pertinent medical history, Last oral intake, Events leading to illness or injury.

Followed by targeted history (pertinent to chief complaint), a.k.a. OPQRST: Onset of pain, what Provokes it, Quality of pain, does it Radiate, Severity of pain, Time (time, time—I always forget how this means).

D. Secondary assessment (head-to-toe, hands on), a.k.a. DCAP-BTLS: Deformities, Contusions, Abrasions, Penetrations, Burns, Tenderness, Lacerations, Swelling

E. Vital signs: pulse, respirations, skin signs (color, temp, moisture, capillary refill), pupils (PERL: equal round, reactive to light + size), blood pressure, pulse oximetry

F. Reassessment

Okay. Now, to study.

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