DOTS Skills Practice

DOTS Skills Practice As you are practicing skills, you will role play with your group. One person will act as the injured victim, while another person will act as the 1st Aid Provider. The third person in your group will act as a coach to make sure you are performing DOTS in a skillful manner, are not skipping steps, and that you are correctly asking the series of questions necessary to determine the extent of the injury. The 3rd person will also act as the EMS to which the 1st Aid Provider will report to at the end of the physical exam. Go slow. At this point in your training, quality is better than speed. As you get more comfortable, you will be able to do this faster. If your group finishes early, practice a different role, and go for a faster speed.

 During this exercise, assume that there are no dangers.

 Use Universal Precautions and PPE (gloves).

 Start from the beginning, with obtaining consent.

 Assume that all victims are “A” on the AVPU scale. However, make sure to ask the necessary questions to determine that he/she is “A” and not “V”

 Decide if you need to do focused DOTS first or Head to Toe DOTS.

 Make sure to always talk and explain to the victim everything you are doing during the physical exam and why. This will keep your victim calm.

 When you “discover” the area of injury, begin asking OPQRST questions to probe deeper into the nature or cause of the injury. But be gentle. Remember your victim is in pain. Not all OPQRST questions are applicable to the scenarios.

 Take a SAMPLE history.

 End with a report to the EMS (3rd party) of the nature of the injury. Try to infer what the problem might be.

 Practice BSI removing your gloves properly, then go wash your hands using WHO guidelines.

Scenario 1: Victim is an elderly person who was taking a walk in the neighborhood. He trips over the sidewalk and falls. Initially, there is no apparent visible injury. There is no medical alert tag, but he is on blood pressure medication and is allergic to penicillin antibiotic. During the physical exam, victim complains of a sharp pain in the hip bones. The pain in mostly on the anterior right side of the hip and radiates deep into the pelvic region. 1 st Aid provider witnesses the fall and comes to help.

Scenario 2: Victim is a middle age adult that works with you. He has called in sick the past two days, complaining of a mild stomach ache that has progressively gotten worst. He, grudgingly, shows up to work because he does not want to miss any more days, but he is in severe pain and has severe difficulty concentrating at work because of it. During lunch, victim buckles over, clutching his right lower quadrant of his abdomen. 1st Aid Provider (friend) is worried, and offers to do a physical exam.

Scenario 3: Victim is a sophomore in college, and is in martial arts. During a match, he is forced to forfeit after a direct kick to the thoracic area. 1st Aid provider was in the health facilities, and did not witness the match or the traumatic contact, but there were plenty of witnesses. During examination, victim complains of tenderness in the ribs. Pain is sharp on the left side when victim breathes in deeply, but lessens with more shallow breaths. He is also aching all over with “normal” muscle soreness from the match, but there seems to be mild swelling and tenderness on the left anterior carpels. This is more of a dull, throbbing pain. The digits are also swollen and his middle and left ring finger are blue.