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MCCCD EMT 104 - Patient Assessment

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Class 4 (Scene Size-Up with MOI, Manual Spinal, Skeletal A&P & Lifting/Moving Patients) Ch8 (Partial), Ch21, Ch30 (Partial), Ch4 (Partial) & Ch6Patient Assessment Roadmap (Review)Scene Size-upKinematics of TraumaTraumatic InjuriesMechanism of Injury (MOI)Vehicular Crashes and MOIVehicular CollisionsSignificant MOITypes of Motor Vehicle CollisionsFrontal Collisions (1 of 2)Frontal Collisions (2 of 2)Rear-End CollisionsLateral CollisionsRollover CrashesSpinsCar-Versus-Pedestrian CollisionsFallsConsiderations for FallsPenetrating TraumaLow-Energy Penetrating TraumaMedium-Velocity and High-Velocity Penetrating TraumaManual Stabilization of the Cervical SpineManual Stabilization of the Cervical SpineThe Planes of the BodyMovement TermsDirectional TermsAnatomic Positions (1 of 2)Anatomic Positions (2 of 2)Recovery PositionThe Skeletal SystemThe SkullThe NeckThe Spinal ColumnThe ThoraxPrincipal Organs of the ThoraxThe Abdomen (1 of 2)The Abdomen (2 of 2)The PelvisThe Lower ExtremityThe Upper ExtremityHand & FootJointsInstructor…Patient-Moving Equipment (1 of 3)Patient-Moving Equipment (2 of 3)Patient-Moving Equipment (3 of 3)Wheeled Ambulance StretcherLoading the Wheeled Ambulance CotMoving and Positioning the PatientBody MechanicsPerforming the Power Grip (1 of 2)Performing the Power Grip (2 of 2)Performing the Power Lift (1 of 3)Slide 55InstructorWeight and DistributionDiamond CarryOne-Handed CarryingSlide 60Carrying Backboard or Cot on StairsUsing a Stair ChairScoop StretcherGeneral ConsiderationsDirections and CommandsAdditional GuidelinesPrinciples of Safe Reaching and Pulling (1 of 3)Principles of Safe Reaching and Pulling (2 of 3)Principles of Safe Reaching and Pulling (3 of 3)Emergency MovesEmergency Drags (1 of 2)Emergency Drags (2 of 2)One-Person Rapid ExtricationOne-Rescuer Drags, Carries, and Lifts (1 of 3)One-Rescuer Drags, Carries, and Lifts (2 of 3)One-Rescuer Drags, Carries, and Lifts (3 of 3)Urgent MovesWhen to Use Rapid Extrication TechniqueRapid Extrication (1 of 3)Rapid Extrication (2 of 3)Rapid Extrication (3 of 3)Nonurgent Moves (1 of 2)Nonurgent Moves (2 of 2)Transfer MovesGeriatricsBariatricsClass 4 (Scene Size-Up with MOI, Manual Spinal, Skeletal A&P & Lifting/Moving Patients)Ch8 (Partial), Ch21, Ch30 (Partial), Ch4 (Partial) & Ch6Patient Assessment Roadmap (Review)•Scene size-up•Initial assessment•Focused history and physical exam–Examination•Rapid•Focused–History–Vital signs•Detailed physical exam•Ongoing assessmentScene Size-up•Dispatch information•Inspection of scene•Scene hazards•Safety concerns•Mechanism of injury•Nature of illness/chief complaint•Number of patients•Additional resources neededKinematics of Trauma•Injuries are the leading cause of death among children and young adults.•Kinematics introduces the basic physical concepts that dictate how injuries occur and affect the human body.•Helps determine mechanism of injuryTraumatic Injuries •Blunt trauma –Caused by a force to the body–Injuries do not penetrate soft tissue or organs•Penetrating trauma –Caused by objects such as knives and bullets–Injuries pierce the surface of the bodyMechanism of Injury (MOI)•MOI is the way in which traumatic injuries occur. •Different MOIs produce many types of injuries.–Isolated to one body system–Injuries to many body systemsVehicular Crashes and MOI•By assessing the crash, the MOI may be determined.•By determining the MOI, you may be able to predict the types of injuries that may have happened at the time of impact.•Index of suspicionVehicular Collisions•Three types of crashes–Collision of car against another car or object–Collision of passenger(s) against interior of car–Collision of passenger’s internal organs against the solid structures of the bodySignificant MOI•Severe deformities to the frontal part of the vehicle•Moderate intrusion from a T-bone accident•Severe damage from the rear•Collisions in which rotation is involved•Death of an occupant–High index of suspicion for other patientsTypes of Motor Vehicle Collisions•Frontal•Lateral•Rear-end•Rollovers•SpinsFrontal Collisions (1 of 2)•Evaluate seat belts and airbags.•Remember that supplemental restraint systems cannot prevent all injuries.–You should still suspect that serious injuries have occurred.Frontal Collisions (2 of 2)•Check for contact points.•Steering wheels can also cause chest injuries, especially if no airbag is present.•Dashboard can cause lower extremity injury•Common injury patterns–Up & over–Down & underRear-End Collisions•Commonly cause whiplash-type injuries•Unrestrained passengers will be thrust forward into the dashboard.•Back seat passengers wearing only lap belts might have a higher incidence of lumbar and thoracic spine injury.Lateral Collisions•Responsible for the highest incidence of deaths.•Lateral whiplash injury is the result.•There may be intrusion into the passenger compartment.Rollover Crashes•Injury patterns differ if patients are unrestrained.•The most unpredictable injuries are to unrestrained passengers.•Ejection is the most common life-threatening injury.Spins•Vehicle is put into rotational motion.•Vehicle often strikes a fixed object, combining forces of rotation with lateral impact.Car-Versus-Pedestrian Collisions•Often cause serious injuries to body systems•Evaluate MOI to determine:–Whether patient was thrown and how far.–Whether patient was struck and pulled under car.•Presume injury to the spinal cord and maintain immobilization.Falls•Injury potential is related to the height of the fall.•A fall either 15' or three times the person’s height is considered significant.•Suspect internal injuries from a significant fall.Considerations for Falls•The height of the fall•The surface struck•The part of the body that hit first, followed by the path of energy displacement•Always consider syncope or other medical conditions as an underlying cause.Penetrating Trauma•Second largest cause of death in the United States after blunt trauma•Penetration can be low-energy, or medium- or high-velocity.•The greater the speed of penetration, the greater the injuries.–Kinetic energy = mass times the square of velocity–KE = Mass X (Speed)2Low-Energy Penetrating Trauma•Caused accidentally by an object or intentionally with a weapon•Injury caused by the sharp edges of the object moving through the


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MCCCD EMT 104 - Patient Assessment

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