Chapter 3 Victim AssessmentLearning ObjectivesIn most cases, conduct victim assessment in this order:Conduct a Scene Size-UpEstablishing Rapport and ControlTo establish control of the scene, do the following:Progress CheckConducting the Primary SurveyBreathingCirculationVocabularyDisabilityPROGRESS CHECK3.3 Conducting the Neuro ExamVital SignsSlide 16Slide 17When taking a history:SAMPLEDuring the survey, use the following approach:DOTSSlide 22Face, Mouth, Ears, NoseSkull and NeckChestAbdomenPelvic RegionLower ExtremitiesUpper ExtremitiesSlide 30KEY TERMS11Chapter 3Chapter 3Victim AssessmentVictim Assessment22Learning ObjectivesLearning ObjectivesWhen you have mastered the material in this chapter, you will be When you have mastered the material in this chapter, you will be able toable to1 1 Understand how to properly assess a victimUnderstand how to properly assess a victim2 2 Describe how to establish rapport with the victimDescribe how to establish rapport with the victim3 3 Explain how to survey and control the sceneExplain how to survey and control the scene4 4 Describe and conduct a primary surveyDescribe and conduct a primary survey5 5 Know how to conduct a neurologic examKnow how to conduct a neurologic exam6 6 Explain how to determine the chief complaintExplain how to determine the chief complaint7 7 Understand the significance of vital signs (pulse, respiration, and Understand the significance of vital signs (pulse, respiration, and relative skin temperature)relative skin temperature)8 8 Explain how to take a historyExplain how to take a history9 9 Understand the sequence and practical application of a Understand the sequence and practical application of a secondary surveysecondary survey33In most cases, conduct victim In most cases, conduct victim assessment in this order: assessment in this order: 1. 1. Conduct a scene size-up.Conduct a scene size-up.2. 2. Establish rapport and control.Establish rapport and control.3. 3. Conduct a primary survey.Conduct a primary survey.4. 4. Conduct a brief neurologic (i.e., “neuro”) exam.Conduct a brief neurologic (i.e., “neuro”) exam.55. Determine the chief complaint.. Determine the chief complaint.6. 6. Assess vital signs.Assess vital signs.7. 7. Look for medical information devices.Look for medical information devices.8. 8. Take a SAMPLE history.Take a SAMPLE history.9. 9. Conduct a secondary survey.Conduct a secondary survey.You may need to adapt or change the sequence,You may need to adapt or change the sequence,depending on your experience and the specific emergencydepending on your experience and the specific emergencysituation.situation.44Conduct a Scene Size-UpConduct a Scene Size-Up1. 1. Take body substance isolation Take body substance isolation precautions by using personal protective precautions by using personal protective equipment (PPE), if possible.equipment (PPE), if possible.2. 2. Assess the safety of the scene.Assess the safety of the scene.33. Determine if the victim is injured or ill.. Determine if the victim is injured or ill.4. 4. Determine the number of victims.Determine the number of victims.5. 5. Determine the resources needed.Determine the resources needed.55Establishing Rapport and Establishing Rapport and ControlControlThree C’s:Three C’s:CCompetenceompetenceCConfidenceonfidenceCCompassionompassion66To establish control of the scene, To establish control of the scene, do the followingdo the following::Move smoothly and deliberately.Move smoothly and deliberately.Position yourself at a comfortable level in relation Position yourself at a comfortable level in relation to the victim. Stay where the victim can see you to the victim. Stay where the victim can see you without twisting his or her neck.without twisting his or her neck.Keep your eye level above that of the victim.Keep your eye level above that of the victim.Conduct your survey in an unhurried, systematic Conduct your survey in an unhurried, systematic way.way.Emotions escalate quickly in tense situations, so Emotions escalate quickly in tense situations, so keep your voice calm and quiet.keep your voice calm and quiet.If there is more than one victim, determine which If there is more than one victim, determine which victim(s) needs the most immediate care. victim(s) needs the most immediate care.77Progress CheckProgress Check1. 1. To establish scene control, use the three Cs—To establish scene control, use the three Cs—competence, confidence, and ____________. competence, confidence, and ____________. (control/charisma/compassion)(control/charisma/compassion)2. 2. An important part of introducing yourself to the victim An important part of introducing yourself to the victim is obtaining ____________. is obtaining ____________. (the victim’s name/consent (the victim’s name/consent for treatment/a history of what happened)for treatment/a history of what happened)3. 3. To maintain control, keep your voice __________.To maintain control, keep your voice __________.(calm and deliberate/powerful and authoritative/loud and(calm and deliberate/powerful and authoritative/loud anddemanding)demanding)4. 4. Position yourself with your eye level ____________Position yourself with your eye level ____________that of the victim. that of the victim. (above/even with/below)(above/even with/below)88Conducting the Primary SurveyConducting the Primary Survey1. 1. If the victim is conscious, ask, “What happened?” If the victim is conscious, ask, “What happened?” The response will provide information about the The response will provide information about the airway status, the adequacy of breathing, mental airway status, the adequacy of breathing, mental status, and mechanism of injury or nature of the status, and mechanism of injury or nature of the illness.illness.2. 2. Ask, “Where do you hurt?” The response will Ask, “Where do you hurt?” The response will identify the most likely points of injury.identify the most likely points of injury.3. 3. Visually scan the victim for general appearance, Visually scan the victim for general appearance, pale skin, pale skin, cyanosis cyanosis (blueness from lack of (blueness from lack of oxygen), and sweating.oxygen), and sweating.99BreathingBreathingLook for chest rise and fall.Look for chest rise and fall.Listen for sounds of air movement at Listen for sounds of air movement at the mouth and nose.the mouth and nose.Feel on your