BLS Skill Evaluation Vista Health North Lake County EMS System

Student: Date: TRAUMA ASSESSMENT COMMENTS Takes or verbalizes appropriate body substance isolation SCENE SIZE-UP  Determines the scene/situation is safe, considers scene and environmental risks  Determines the mechanism of injury/nature of illness, significant/non-significant

 Determines the number of patients, triage  Requests additional help if necessary  Considers stabilization of spine INITIAL ASSESSMENT (PRIMARY ASSESSMENT)  Verbalizes general impression of patient/takes appropriate spinal mobilization restrictions  Determines and states responsiveness/level of consciousness (AVPU)  Determines chief complaint/ apparent life-threats/collects consent (implied or expressed)  Opens and assesses airway, patent airway  Inserts adjunct as indicated  Assess breathing and assures adequate ventilation: rate, rhythm, quality  Initiates appropriate oxygen therapy  Manages any injury which may compromise breathing/ventilation  Checks pulse: rate, rhythm, quality  Assess skin (either skin color, temperature or condition)  Assesses for and controls major bleeding if present  Identifies need for shock management, if condition warrants states type of shock DETERMINES TRANSPORT PRIORITY (based on MOI or initial assessment)  Significant MOI or if patient has altered LOC: conduct a Rapid Trauma Assessment  Non-significant MOI: conduct a Focused History and Physical Examination FOCUSED HISTORY AND PHYSICAL EXAMINATION  Selects Appropriate Assessment  Obtains or directs assistant to obtain baseline vital signs

 Obtains SAMPLE History  Provides interventions and identifies potential for rapid progression of hypo-perfusion/shock  Proceeds to Secondary Assessment/Detailed Assessment RAPID TRAUMA ASSESSMENT (PRIMARY ASSESSMENT) Head  Inspects and /palpates for signs of trauma and major life threats Neck  Checks for signs of trauma and major life threats  Checks jugular veins and palpates position of trachea  Checks for subcutaneous emphysema, medical alert tags  Applies C-collar Chest  Inspects and palpates for signs of trauma and major life threats  Quickly auscultates lung sounds and heart tones  If indicated, seals sucking chest wound, stabilizes flail chest and/or impaled objects, decompress tension pneumothorax Abdomen  Inspects and palpates for signs of trauma and major life threats  Palpates abdomen for tenderness, rigidity and distention Pelvis  Inspects and palpates for signs of trauma and major life threats  Verbalizes assessment of genitalia/perineum as needed Lower Extremities  Inspects and palpates for signs of trauma and major life threats  Inspects, palpates, and assesses motor sensory and circulatory functions in each leg Upper Extremities  Inspects and palpates for signs of trauma and major life threats  Inspects, palpates, and assesses motor sensory and circulatory functions in each arm Back  Inspects and palpates for signs of trauma and major life threats  States justification if assessment is not possible (TURN PAGE OVER) COMMENTS

PACKAGE PATIENT/ TRANSPORT DECISION (PRIMARY ASSESSMENT)  If not a critical situation, obtains baseline vital signs and SAMPLE history. If critical, baseline vitals and SAMPLE obtained in Detailed Assessment/Secondary Assessment  If altered LOC, conduct a brief neurological exam  State LOC, Glascow Coma Scale, Motor and Sensation  If pupils are unequal, considers herniation and need for hyperventilation

 Log roll onto unaffected side and onto long board  Use scoop stretcher for suspected pelvic fracture  Confirm transport decision (Continue detailed on scene or conduct detailed enroute)  Contact medical control with abbreviated report if necessary ONGOING ASSESSMENT  Ask patient for changes in how they feel  Reassess Level of Consciousness, airway, breathing and circulation  Reassess Glascow Coma Scale  Reassess vital signs  Reassess neck, chest and abdomen  Reassess injuries and interventions DETAILED PHYSICAL EXAM (SECONDARY ASSESSMENT)  Reassess Level of Consciousness, Airway, Breathing and Circulation  Glasgow Coma Score  Provide routine trauma care  Provide other appropriate treatment as needed  Obtains or directs partners to obtain baseline vital signs (if not already done)  Obtains SAMPLE History from patient or bystanders (if not already done) Head  Inspects/palpates mouth, nose and assesses facial area for DCAP-BTLS-TIC  Inspects and palpates scalp and ears  Assesses eyes for PERRL, raccoon eyes and battle’s signs Neck  Checks position of trachea  Checks jugular veins, subcutaneous emphysema  Inspects/palpates cervical spine and neck for DCAP-BTLS-TIC (If c-collar not applied) Chest  Expose chest  Inspects/palpates chest for DCAP-BTLS-TIC  Ausculates lung sounds and heart tones Abdomen  Expose abdomen  Inspects /Palpates abdomen for DCAP-BTLS, Rigidity and Distension Pelvis  Expose pelvis  Inspects /Palpates abdomen for DCAP-BTLS-TIC  Verbalizes assessment of genitalia/perineum as needed Lower Extremities  Inspects/Palpates for DCAP-BTLS-TIC; assess pulses, motor and sensory Upper Extremities  Inspects/Palpates for DCAP-BTLS-TIC; assess pulses, motor and sensory  Reevaluate transport decision Contact medical control (repeats and clarifies all orders or directives) Critical Actions:  Failure to take or verbalize body substance isolation precautions  Failure to initiate or call for transport of patient within 10 minutes  Failure to determine scene safety  Failure to assess for and provide spinal protection when required  Failure to voice and ultimately provide appropriate high flow oxygen therapy  Failure to find or appropriately manage problems associated with airway, breathing, hemorrhage or shock (hypoperfusion)  Failure to differentiate patient’s need for immediate transportation versus continued assessment and treatment at the scene  Does other detailed or focused history or physical examination before assessing and treating threats to airway, breathing and circulation  Failure to determine the patient’s primary problem  Orders a dangerous or inappropriate intervention Note: You must clearly document your rationale for any failures or critical actions not performed by the student.

Examiner Name: Pass Fail

Current as of June 2018 Follows ITLS Guidelines