tailieunhanh - mosby paramedic (19)

9/10/20121Chapter Assessment2Learning Objectives.• Identify the components of the scene size‐up• Identify the priorities in each component of .patient assessment• Outline the critical steps in primary patient .assessment. 3Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Objectives.• Describe findings in the primary assessment .that may indicate a life‐threatening condition• Discuss interventions for life‐threatening .conditions that are identified in the primary .assessment• Distinguish priorities in the care of the medical .versus trauma patient. 4Scene Size‐Up and Personal Safety.• First steps taken during every response.– Ensure scene safety.•.•.•.•Paramedic (s). assessment and surroundings offer .key information5Scene Size‐Up and Personal Safety.• Scene size‐up priorities.– Determine nature of incident.– Determine maximum potential number of persons .already ill or injured and needing care.– Assess scene for hazards.– Initiate mass casualty plan if indicated6Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Size‐Up and Personal Safety.• Scene size‐up priorities.– Notify dispatch to request more resources and alert area .hospitals as needed.•.•.•.•Law . companies– Determine best access routes and staging areas .for responders.– Secure area, clear unneeded persons from scene.– Begin triage if Size‐Up and Personal Safety.• Scene size‐up priorities.– Scenes that seem safe may still be dangerous.– Never enter potentially unsafe scene until it is safe .to approach patient.•.•.•.•Crash‐and‐rescue with toxic substances and low scenes in which violence is with unsafe surfaces (slope, ice, water)8Do you know a paramedic who has .been injured on a scene? What .caused the injury? Could it have .been prevented?9Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Clothing.• NFPA and OSHA standards adopted by many .response agencies.– Minimum personal protective equipment .• Impact‐resistant protective helmet with ear protection .and chinstrap.• Safety goggles with vents to prevent fogging.• Lightweight, puncture‐resistant turnout coat.• Slip‐resistant waterproof gloves.• Boots with steel insoles and toe protection10Protective Clothing.• NFPA and OSHA standards adopted by many .response agencies.– Minimum personal protective equipment .•.•.•.•.•Self‐contained breathing eye gowns1112Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Protection.• Blood‐borne pathogens.– OSHA Act of 1991 adopted recommendations .established by CDC.• These universal precautions have been adopted by .most states and public service entities.• Minimum standards of practice recommended by OSHA.• Used in case of all patients in which risk of exposure to .blood/body fluids or infection status is unknown.• Wash hands before and after patient contact13Patient Assessment Priorities.• After ensuring scene safety and that needed .resources are available .– Patient assessment can begin.– Assessment priorities.• Primary survey/primary assessment.• Integration of treatment/procedures to preserve life.• Evaluating priority of patient care and transport1415Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company5.

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